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Clinical outcomes of treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis based on ANCA type.

Publication ,  Journal Article
Unizony, S; Villarreal, M; Miloslavsky, EM; Lu, N; Merkel, PA; Spiera, R; Seo, P; Langford, CA; Hoffman, GS; Kallenberg, CM; St Clair, EW ...
Published in: Ann Rheum Dis
June 2016

OBJECTIVE: To evaluate whether the classification of patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) according to ANCA type (anti-proteinase 3 (PR3) or anti-myeloperoxidase (MPO) antibodies) predicts treatment response. METHODS: Treatment responses were assessed among patients enrolled in the Rituximab in ANCA-associated Vasculitis trial according to both AAV diagnosis (granulomatosis with polyangiitis (GPA)/microscopic polyangiitis (MPA)) and ANCA type (PR3-AAV/MPO-AAV). Complete remission (CR) was defined as disease activity score of 0 and successful completion of the prednisone taper. RESULTS: PR3-AAV patients treated with rituximab (RTX) achieved CR at 6 months more frequently than did those randomised to cyclophosphamide (CYC)/azathioprine (AZA) (65% vs 48%; p=0.04). The OR for CR at 6 months among PR3-AAV patients treated with RTX as opposed to CYC/AZA was 2.11 (95% CI 1.04 to 4.30) in analyses adjusted for age, sex and new-onset versus relapsing disease at baseline. PR3-AAV patients with relapsing disease achieved CR more often following RTX treatment at 6 months (OR 3.57; 95% CI 1.43 to 8.93), 12 months (OR 4.32; 95% CI 1.53 to 12.15) and 18 months (OR 3.06; 95% CI 1.05 to 8.97). No association between treatment and CR was observed in the MPO-AAV patient subset or in groups divided according to AAV diagnosis. CONCLUSIONS: Patients with PR3-AAV respond better to RTX than to CYC/AZA. An ANCA type-based classification may guide immunosuppression in AAV. TRIAL REGISTRATION NUMBER: NCT00104299; post-results.

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Published In

Ann Rheum Dis

DOI

EISSN

1468-2060

Publication Date

June 2016

Volume

75

Issue

6

Start / End Page

1166 / 1169

Location

England

Related Subject Headings

  • Treatment Outcome
  • Rituximab
  • Remission Induction
  • Prognosis
  • Peroxidase
  • Myeloblastin
  • Middle Aged
  • Microscopic Polyangiitis
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Unizony, S., Villarreal, M., Miloslavsky, E. M., Lu, N., Merkel, P. A., Spiera, R., … RAVE-ITN Research Group, . (2016). Clinical outcomes of treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis based on ANCA type. Ann Rheum Dis, 75(6), 1166–1169. https://doi.org/10.1136/annrheumdis-2015-208073
Unizony, Sebastian, Miguel Villarreal, Eli M. Miloslavsky, Na Lu, Peter A. Merkel, Robert Spiera, Philip Seo, et al. “Clinical outcomes of treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis based on ANCA type.Ann Rheum Dis 75, no. 6 (June 2016): 1166–69. https://doi.org/10.1136/annrheumdis-2015-208073.
Unizony S, Villarreal M, Miloslavsky EM, Lu N, Merkel PA, Spiera R, et al. Clinical outcomes of treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis based on ANCA type. Ann Rheum Dis. 2016 Jun;75(6):1166–9.
Unizony, Sebastian, et al. “Clinical outcomes of treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis based on ANCA type.Ann Rheum Dis, vol. 75, no. 6, June 2016, pp. 1166–69. Pubmed, doi:10.1136/annrheumdis-2015-208073.
Unizony S, Villarreal M, Miloslavsky EM, Lu N, Merkel PA, Spiera R, Seo P, Langford CA, Hoffman GS, Kallenberg CM, St Clair EW, Ikle D, Tchao NK, Ding L, Brunetta P, Choi HK, Monach PA, Fervenza F, Stone JH, Specks U, RAVE-ITN Research Group. Clinical outcomes of treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis based on ANCA type. Ann Rheum Dis. 2016 Jun;75(6):1166–1169.

Published In

Ann Rheum Dis

DOI

EISSN

1468-2060

Publication Date

June 2016

Volume

75

Issue

6

Start / End Page

1166 / 1169

Location

England

Related Subject Headings

  • Treatment Outcome
  • Rituximab
  • Remission Induction
  • Prognosis
  • Peroxidase
  • Myeloblastin
  • Middle Aged
  • Microscopic Polyangiitis
  • Male
  • Humans