Difference between revisions of "Warm autoimmune hemolytic anemia"
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===References=== | ===References=== | ||
− | #'''RAIHA:''' Michel M, Terriou L, Roudot-Thoraval F, Hamidou M, Ebbo M, Le Guenno G, Galicier L, Audia S, Royer B, Morin AS, Marie Michot J, Jaccard A, Frenzel L, Khellaf M, Godeau B. A randomized and double-blind controlled trial evaluating the safety and efficacy of rituximab for warm auto-immune hemolytic anemia in adults (the RAIHA study). Am J Hematol. 2017 Jan;92(1):23-27. Epub 2016 Nov 10. [https://doi.org/10.1002/ajh.24570 link to original article] ''' | + | #'''RAIHA:''' Michel M, Terriou L, Roudot-Thoraval F, Hamidou M, Ebbo M, Le Guenno G, Galicier L, Audia S, Royer B, Morin AS, Marie Michot J, Jaccard A, Frenzel L, Khellaf M, Godeau B. A randomized and double-blind controlled trial evaluating the safety and efficacy of rituximab for warm auto-immune hemolytic anemia in adults (the RAIHA study). Am J Hematol. 2017 Jan;92(1):23-27. Epub 2016 Nov 10. [https://doi.org/10.1002/ajh.24570 link to original article] '''dosing details in abstract have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/27696475/ PubMed] [https://clinicaltrials.gov/study/NCT01181154 NCT01181154] |
==Prednisolone & Rituximab {{#subobject:598gf2|Regimen=1}}== | ==Prednisolone & Rituximab {{#subobject:598gf2|Regimen=1}}== | ||
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===References=== | ===References=== | ||
− | #'''RAIHA:''' Michel M, Terriou L, Roudot-Thoraval F, Hamidou M, Ebbo M, Le Guenno G, Galicier L, Audia S, Royer B, Morin AS, Marie Michot J, Jaccard A, Frenzel L, Khellaf M, Godeau B. A randomized and double-blind controlled trial evaluating the safety and efficacy of rituximab for warm auto-immune hemolytic anemia in adults (the RAIHA study). Am J Hematol. 2017 Jan;92(1):23-27. Epub 2016 Nov 10. [https://doi.org/10.1002/ajh.24570 link to original article] ''' | + | #'''RAIHA:''' Michel M, Terriou L, Roudot-Thoraval F, Hamidou M, Ebbo M, Le Guenno G, Galicier L, Audia S, Royer B, Morin AS, Marie Michot J, Jaccard A, Frenzel L, Khellaf M, Godeau B. A randomized and double-blind controlled trial evaluating the safety and efficacy of rituximab for warm auto-immune hemolytic anemia in adults (the RAIHA study). Am J Hematol. 2017 Jan;92(1):23-27. Epub 2016 Nov 10. [https://doi.org/10.1002/ajh.24570 link to original article] '''dosing details in abstract have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/27696475/ PubMed] [https://clinicaltrials.gov/study/NCT01181154 NCT01181154] |
[[Category:Warm autoimmune hemolytic anemia regimens]] | [[Category:Warm autoimmune hemolytic anemia regimens]] | ||
[[Category:Disease-specific pages]] | [[Category:Disease-specific pages]] | ||
[[Category:Autoimmune hematologic conditions]] | [[Category:Autoimmune hematologic conditions]] | ||
[[Category:Hemolytic process]] | [[Category:Hemolytic process]] |
Latest revision as of 23:38, 15 July 2024
Section editor | |
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Benjamin Tillman, MD Vanderbilt University Nashville, TN, USA |
- We have moved How I Treat articles to a dedicated page.
4 regimens on this page
3 variants on this page
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Guidelines
Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.
British Society for Haematology
- 2017: Guidelines on the management of drug-induced immune and secondary autoimmune, haemolytic anaemia PubMed
- 2016: The diagnosis and management of primary autoimmune haemolytic anaemia PubMed
All lines of therapy
Prednisolone monotherapy
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Birgens et al. 2013 (AIHA-KA04062-gms) | 2005-03 to 2012-06 | Phase 3 (C) | Prednisolone & Rituximab | Seems to have inferior RFS |
Immunosuppressive therapy
- Prednisolone (Millipred) 1.5 mg/kg/day PO for 2 weeks, then 0.75 mg/kg/day PO for 1 week (week 3), then 0.5 mg/kg/day PO for 1 week (week 4), then a gradual reduction over the next 4-8 weeks to the lowest dose that was effective in maintaining a normal hemoglobin level.
References
- AIHA-KA04062-gms: Birgens H, Frederiksen H, Hasselbalch HC, Rasmussen IH, Nielsen OJ, Kjeldsen L, Larsen H, Mourits-Andersen T, Plesner T, Rønnov-Jessen D, Vestergaard H, Klausen TW, Schöllkopf C. A phase III randomized trial comparing glucocorticoid monotherapy versus glucocorticoid and rituximab in patients with autoimmune haemolytic anaemia. Br J Haematol. 2013 Nov;163(3):393-9. Epub 2013 Aug 24. link to original article PubMed NCT01134432
Prednisone monotherapy
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Michel et al. 2016 (RAIHA) | 2011-2015 | Phase 3 (C) | Prednisone & Rituximab | Seems to have inferior ORR |
Immunosuppressive therapy
- Prednisone (Sterapred) 1 mg/kg PO once per day on days 1 to 14, then tapered "according to a pre-defined recommended reduction scheme"
One course
References
- RAIHA: Michel M, Terriou L, Roudot-Thoraval F, Hamidou M, Ebbo M, Le Guenno G, Galicier L, Audia S, Royer B, Morin AS, Marie Michot J, Jaccard A, Frenzel L, Khellaf M, Godeau B. A randomized and double-blind controlled trial evaluating the safety and efficacy of rituximab for warm auto-immune hemolytic anemia in adults (the RAIHA study). Am J Hematol. 2017 Jan;92(1):23-27. Epub 2016 Nov 10. link to original article dosing details in abstract have been reviewed by our editors PubMed NCT01181154
Prednisolone & Rituximab
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Birgens et al. 2013 (AIHA-KA04062-gms) | 2005-03 to 2012-06 | Phase 3 (E-esc) | Prednisolone | Seems to have superior RFS (secondary endpoint) |
Immunosuppressive therapy
- Prednisolone (Millipred) 1.5 mg/kg/day PO for 2 weeks, then 0.75 mg/kg/day PO for 1 week (week 3), then 0.5 mg/kg/day PO for 1 week (week 4), then a gradual reduction over the next 4 to 8 weeks to the lowest dose that was effective in maintaining a normal hemoglobin level.
- Rituximab (Rituxan) 375 mg/m2 IV once per week for 4 weeks
Supportive therapy
- Folic acid 5 mg/day PO
References
- AIHA-KA04062-gms: Birgens H, Frederiksen H, Hasselbalch HC, Rasmussen IH, Nielsen OJ, Kjeldsen L, Larsen H, Mourits-Andersen T, Plesner T, Rønnov-Jessen D, Vestergaard H, Klausen TW, Schöllkopf C. A phase III randomized trial comparing glucocorticoid monotherapy versus glucocorticoid and rituximab in patients with autoimmune haemolytic anaemia. Br J Haematol. 2013 Nov;163(3):393-9. Epub 2013 Aug 24. link to original article PubMed NCT01134432
Prednisone & Rituximab
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Michel et al. 2016 (RAIHA) | 2011-2015 | Phase 3 (E-esc) | Prednisone | Seems to have superior ORR (primary endpoint) |
Immunosuppressive therapy
- Prednisone (Sterapred) 1 mg/kg PO once per day on days 1 to 14, then tapered "according to a pre-defined recommended reduction scheme"
- Rituximab (Rituxan) 1000 mg IV once per day on days 1 & 15
One course
References
- RAIHA: Michel M, Terriou L, Roudot-Thoraval F, Hamidou M, Ebbo M, Le Guenno G, Galicier L, Audia S, Royer B, Morin AS, Marie Michot J, Jaccard A, Frenzel L, Khellaf M, Godeau B. A randomized and double-blind controlled trial evaluating the safety and efficacy of rituximab for warm auto-immune hemolytic anemia in adults (the RAIHA study). Am J Hematol. 2017 Jan;92(1):23-27. Epub 2016 Nov 10. link to original article dosing details in abstract have been reviewed by our editors PubMed NCT01181154