Increase of antimyeloperoxidase antineutrophil cytoplasmic antibody (ANCA) in patients with renal ANCA-associated vasculitis: Association with risk to relapse

Makoto Yamaguchi, Masahiko Ando, Sawako Kato, Takayuki Katsuno, Noritoshi Kato, Tomoki Kosugi, Waichi Sato, Naotake Tsuboi, Yoshinari Yasuda, Masashi Mizuno, Yasuhiko Ito, Seiichi Matsuo, Shoichi Maruyama

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Objective. The diagnostic values of antiproteinase 3 and antimyeloperoxidase tests using antineu-trophil cytoplasmic antibodies (ANCA) are well established. Our study determined whether an increase in ANCA level was a predictor of disease flareup. Methods. Our study included 126 patients with ANCA-associated renal vasculitis treated at 9 nephrology centers in Japan. The relationship between increased ANCA levels and relapse was assessed using time-dependent multivariate Cox regression models adjusted for clinically relevant factors. The outcome of interest was the time from remission to first relapse. Results. During the observation period [median 41 mos, interquartile range (IQR) 23-66 mos], 118 patients (95.8%) achieved remission at least once. After achieving remission, 34 patients relapsed (21.7%). Time-dependent multivariate Cox regression models revealed that lung involvement (adjusted HR 2.29, 95% CI 1.13-4.65, p = 0.022) and increased ANCA levels (adjusted HR 17.4, 95% CI 8.42-36.0, p < 0.001) were significantly associated with relapse. The median time from ANCA level increase to relapse was 0.6 months (IQR 0-2.1 mos). Conclusion. In our study, an increase in ANCA level during remission was associated with a risk of disease relapse. A rise in ANCA level may be useful for guiding treatment decisions in appropriate subsets of patients with ANCA-associated vasculitis.

Original languageEnglish
Pages (from-to)1853-1860
Number of pages8
JournalJournal of Rheumatology
Volume42
Issue number10
DOIs
Publication statusPublished - 01-10-2015

All Science Journal Classification (ASJC) codes

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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