Moura MC, Irazabal MV, Eirin A, et al. - Since treatment of cases of ANCA-associated vasculitis (AAV) and severe renal involvement is not established, therefore, researchers undertook this retrospective cohort study to define results in response to rituximab (RTX) vs cyclophosphamide (CYC) and plasma exchange (PLEX). This study involved MPO- or PR3-ANCA–positive patients with AAV (MPA and GPA) and severe renal disease (eGFR <30 ml/min per 1.73 m²). Experts compared remission, relapse, ESKD as well as mortality following remission-induction with CYC or RTX, with or without the use of PLEX. eGFR <15 ml/min per 1.73 m² at diagnosis, renal recovery and renal remission at 6 months, all were identified as predictors for ESKD and/or death at 18 months. According to the findings, for the treatment of patients with AAV and severe renal disease, the apparent advantages and risks of using CYC or RTX were balanced. In this cohort, findings demonstrated no benefit of the addition of PLEX to standard remission-induction therapy.