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Negative anti-neutr...
Negative anti-neutrophil cytoplasm antibody at switch to maintenance therapy is associated with a reduced risk of relapse
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- Morgan, Matthew David (författare)
- University of Birmingham,New Queen Elizabeth Hospital
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- Szeto, Matthew (författare)
- University of Birmingham
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- Walsh, Michael (författare)
- McMaster University
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- Jayne, David (författare)
- University of Cambridge
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- Westman, Kerstin (författare)
- Lund University,Lunds universitet,Njurmedicin,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Autoimmunitet och njursjukdomar,Forskargrupper vid Lunds universitet,Nephrology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Autoimmunity and kidney diseases,Lund University Research Groups,Skåne University Hospital
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- Rasmussen, Niels (författare)
- Danish Serum Institute, Copenhagen
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- Hiemstra, Thomas F (författare)
- University of Cambridge
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- Flossmann, Oliver (författare)
- Royal Berkshire Hospital
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- Berden, Annelies (författare)
- Leiden University Medical Centre
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- Höglund, Peter (författare)
- Lund University,Lunds universitet,Avdelningen för klinisk kemi och farmakologi,Institutionen för laboratoriemedicin,Medicinska fakulteten,Artificiell intelligens och thoraxkirurgisk vetenskap (AICTS),Forskargrupper vid Lunds universitet,Kliniska studier vid kronisk njursjukdom (CKD),Proteasinhibitorforskning,Division of Clinical Chemistry and Pharmacology,Department of Laboratory Medicine,Faculty of Medicine,Artificial Intelligence in CardioThoracic Sciences (AICTS),Lund University Research Groups,Clinical studies in CKD,Protease Inhibitor Research,Skåne University Hospital
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- Harper, Lorraine (författare)
- University of Birmingham
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(creator_code:org_t)
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- 2017-06-07
- 2017
- Engelska.
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Ingår i: Arthritis Research and Therapy. - : Springer Science and Business Media LLC. - 1478-6354 .- 1478-6362. ; 19:1
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://doi.org/10.1...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background: Relapse of disease is frequent in anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV). It is unclear whether persistent ANCA when starting maintenance therapy increases the risk of relapse. We examined the association between ANCA status and relapse in two randomised controlled trials. Methods: ANCA-positive patients in two trials, CYCLOPS and IMPROVE, were switched from cyclophosphamide to maintenance therapy after achieving clinical remission. We classified patients as being either ANCA-positive or ANCA-negative at the time they started maintenance therapy. We compared the risk of relapse in ANCA-positive and ANCA-negative patients. Results: Of 252 patients included, 102 (40%) experienced at least one relapse during the follow-up period. At the time of the switch from induction to maintenance therapy, 111 were ANCA-positive, of whom 55 (50%) relapsed, compared to 141 patients who were ANCA-negative, of whom 47 (33%) relapsed. In multivariable time-to-event analysis, a reduced risk of relapse was associated with having become ANCA-negative at the time of switching to maintenance therapy (hazard ratio 0.63, 95% confidence interval 0.42-0.95; p=0.026). In addition, initial proteinase 3 (PR3)-ANCA, younger age, lower serum creatinine, pulsed cyclophosphamide for remission induction, and mycophenolate mofetil for remission maintenance were all associated with an increased risk of relapse. Conclusions: Becoming ANCA-negative before the switch to maintenance is associated with a reduced risk of relapse. Trial registration: CYCLOPS: ClinicalTrials.gov, NCT00430105. Registered retrospectively on 31 January 2007. IMPROVE: ClinicalTrials.gov, NCT00307645. Registered retrospectively on 27 March 2006.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Nyckelord
- ANCA
- ANCA-associated vasculitis
- Clinical trial
- Prognostic factors
- Relapse
- Treatment
- Vasculitis
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Morgan, Matthew ...
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Szeto, Matthew
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Walsh, Michael
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Jayne, David
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Westman, Kerstin
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Rasmussen, Niels
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visa fler...
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Hiemstra, Thomas ...
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Flossmann, Olive ...
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Berden, Annelies
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Höglund, Peter
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Harper, Lorraine
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Urologi och njur ...
- Artiklar i publikationen
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Arthritis Resear ...
- Av lärosätet
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Lunds universitet