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AAV Maintenance After Rituximab — ESENeph MCQ

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HardRenal VasculitisAAV Maintenance After RituximabESENeph

A 42-year-old man with ANCA-associated vasculitis (PR3-ANCA) has achieved remission after induction with Rituximab and Glucocorticoids. KDIGO 2024 recommends maintenance therapy. Which maintenance regimen is preferred following Rituximab induction?

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Correct answer: C — Rituximab maintenance

KDIGO 2024 AAV guideline recommends maintenance therapy with either Rituximab or Azathioprine plus low-dose glucocorticoids after induction of remission (1C). Following Rituximab induction, maintenance immunosuppressive therapy should be given to most patients. The MAINRITSAN trial showed Rituximab maintenance was superior to Azathioprine in preventing relapse. PR3-ANCA positivity is a risk factor for relapse, further supporting Rituximab maintenance.

Reference: KDIGO 2024 – ANCA-Associated Vasculitis Guideline