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Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (including Wegener granulomatosis, Churg-Strauss syndrome, and microscopic polyangiitis) can be severe, even life-threatening. Cutaneous manifestations, including small vessel vasculitis, are common. Oral or intravenous corticosteroids and intravenous or oral cyclophosphamide produce remission in many patients. However, these agents are associated with heightened risk for infection and malignancy.
Reduction of circulating ANCA levels is associated with remission. Because ANCA is a B-cell–derived antibody, it is reasonable that rituximab, a CD20-depleting B-lymphocyte–associated antigen, might produce remission with less short- and long-term toxicity. Two randomized, controlle…