Rationale of concomitant cyclophosphamide for remission-induction in patients with antineutrophil cytoplasmic antibody-associated vasculitis: A propensity score-matched analysis of two nationwide prospective cohort studies.

Published on Jan 2, 2021in Modern Rheumatology2.113
· DOI :10.1080/14397595.2019.1707997
Haruki Watanabe8
Estimated H-index: 8
(Okayama University),
Ken Ei Sada19
Estimated H-index: 19
(Okayama University)
+ 9 AuthorsWelfare for Intractable Vasculitis Syndrome
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Abstract
AbstractObjectives: We evaluated the effectiveness of cyclophosphamide for patients with microscopic polyangiitis and granulomatosis with polyangiitis.Methods: Patients treated with cyclophosphamid...
References30
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#1Rachel B JonesH-Index: 22
#2Thomas F. HiemstraH-Index: 13
Last. David JayneH-Index: 98
view all 19 authors...
Objectives Cyclophosphamide induction regimens are effective for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), but are associated with infections, malignancies and infertility. Mycophenolate mofetil (MMF) has shown high remission rates in small studies of AAV. Methods We conducted a randomised controlled trial to investigate whether MMF was non-inferior to cyclophosphamide for remission induction in AAV. 140 newly diagnosed patients were randomly assigned to MMF or puls...
69 CitationsSource
#1Masayoshi HarigaiH-Index: 44
#2Kenji Nagasaka (Tokyo Medical and Dental University)H-Index: 14
Last. Yoshihiro Arimua (Kyorin University)H-Index: 1
view all 17 authors...
AbstractObjective: The Japan Research Committee for Intractable Vasculitis has fully revised the clinical practice guidelines (CPG) for the management of antineutrophil cytoplasmic antibody-associa...
21 CitationsSource
OBJECTIVE: To evaluate clinical links between levels of myeloperoxidase (MPO)-antineutrophil cytoplasmic antibody (ANCA) and relapse in patients with ANCA-associated vasculitis (AAV) using a data set from 2 nationwide prospective cohort studies. METHODS: From the cohort studies, MPO-ANCA-positive patients who achieved remission during the 6 months after remission induction therapy were enrolled. We measured MPO-ANCA levels at months 0, 3, 6, 12, 18, 24, and at the time of relapse. The primary ou...
16 CitationsSource
AbstractLymphoproliferative disorders (LPD) in patients receiving methotrexate (MTX) have gained strong attention. In this article, I reviewed the basic and clinical findings of this issue. Patients with RA possess a high risk of lymphoma, but epidemiological evidence showing an association between the use of MTX and lymphoma is still limited. Rapid regression of LPD after stopping MTX in patients with RA strongly suggests that there is a causative relationship. Genetic predisposition, accumulat...
37 CitationsSource
#2Masayoshi HarigaiH-Index: 44
Last. Hirofumi Makino (Okayama University)H-Index: 98
view all 13 authors...
AbstractObjectives: The purpose of this study was to identify the clinical characteristics and predictors of serious infections (SIs) in the RemIT-JAV, a nationwide, prospective, inception cohort study for Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV).Methods: We analyzed SIs within six months of remission induction therapy in 156 AAV patients. Hazard ratios with 95% confidence intervals (CIs) for SIs were calculated using the COX proportional hazard mode...
12 CitationsSource
#1Yoon Jeong Oh (Yonsei University)H-Index: 2
#2Sung Soo Ahn (Yonsei University)H-Index: 23
Last. Sang Won Lee (Yonsei University)H-Index: 24
view all 7 authors...
OBJECTIVES: We investigated whether specified organ involvements, antineutrophil cytoplasmic antibody (ANCA) positivity, Birmingham vasculitis activity score (BVAS) and five factor scores (FFS) at diagnosis could predict relapse of microscopic polyangiitis (MPA). METHODS: We reviewed the medical records of 90 patients with MPA. We collected clinical and prognostic data, (MPO)-ANCA and proteinase 3 (PR3)-ANCA, BVAS and FFS at diagnosis, and we compared them between the two groups. The optimal cut...
23 Citations
#1Kiyoki KitagawaH-Index: 15
#2Kengo Furuichi (Kanazawa University)H-Index: 5
Last. Takashi Wada (Kanazawa University)H-Index: 61
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Background The prevention of relapse and infection complications during remission maintenance therapy is required to improve the prognosis of patients with microscopic polyangiitis (MPA) showing rapidly progressive glomerulonephritis (RPGN). The clinicopathological characteristics of patients with ANCA-positive MPA were examined to determine the risk factors for relapse or infectious complications after remission induction therapy.
12 CitationsSource
#1Masashi IwabuchiH-Index: 4
#2Izaya NakayaH-Index: 11
Last. Jun SomaH-Index: 16
view all 11 authors...
Background The aim of this study was to determine the efficacy of cyclophosphamide (CY) on anti-neutrophil cytoplasmic antibody (ANCA)-positive microscopic polyangiitis (MPA) with renal involvement in Japanese patients.
3 CitationsSource
#1Max Yates (UEA: University of East Anglia)H-Index: 9
#2Richard A. Watts (UEA: University of East Anglia)H-Index: 64
Last. Chetan Mukhtyar (NNUH: Norfolk and Norwich University Hospital)H-Index: 21
view all 22 authors...
In this article, the 2009 European League Against Rheumatism (EULAR) recommendations for the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) have been updated. The 2009 recommendations were on the management of primary small and medium vessel vasculitis. The 2015 update has been developed by an international task force representing EULAR, the European Renal Association and the European Vasculitis Society (EUVAS). The recommendations are based upon evidence fr...
519 CitationsSource
#1Ken Ei Sada (Okayama University)H-Index: 19
#2Masayoshi Harigai (Tokyo Medical and Dental University)H-Index: 44
Last. Hirofumi Makino (Okayama University)H-Index: 98
view all 21 authors...
AbstractObjective: To compare disease severity classification systems for six-month outcome prediction in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).Methods: Patients with newly diagnosed AAV from 53 tertiary institutions were enrolled. Six-month remission, overall survival, and end-stage renal disease (ESRD)-free survival were evaluated.Results: According to the European Vasculitis Study Group (EUVAS)-defined disease severity, the 321 enrolled patients ...
21 CitationsSource
Cited By1
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#1Ken Ei Sada (Kōchi University)H-Index: 19
#2Keiji Ohashi (Kōchi University)H-Index: 1
view all 16 authors...
BACKGROUND It is not elucidated that there is treatment-related damage in elderly patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). METHODS Elderly (≥ 75 years of age) patients were enrolled from two nationwide prospective inception cohort studies. The primary outcome was 12-month treatment-related Vasculitis Damage Index (VDI) score. Secondary outcomes included serious infections within 6 months, total VDI score, remission, and relapse. Patient characteristic...
3 CitationsSource