Sustained Remission Off Therapy Unlikely in GPA Save

A French Vasculitis Study Group analysis of their granulomatosis with polyangiitis (GPA) reveals that after 10 years, only 7% of GPA patients achieved sustained remission off therapy (SROT) and have never relapsed.

This registry included 795 GPA patients. They defined SROT as remission (BVAS=0) without glucocorticoids (GC) or immunosuppressants (IS) for ≥6 consecutive months.

Three years postdiagnosis, 92 SROT patients were compared to 342 controls who had relapsed and/or were still taking GC or IS.

While baseline characteristics were not different between cohorts; those achieving SROT at 3 years were more apt to be treated with intravenous cyclophosphamide‐induction therapy (P=0.01).

By 5 years, those in SROT‐year were again more likely to receive cyclophosphamide infusions (P=0.03), but also rituximab‐maintenance therapy (5‐year, P<0.001).

There were 74 GPA Registry patients with 10‐year follow‐up data after conventional maintenance therapy; 15 (20%) had achieved SROT at 3 years and 5 (7%) maintained it at 10 years.

Even with more intensive therapy, sustained remission off therapy was unlikely in GPA patients.