TY - JOUR
T1 - Smoking is a risk factor for relapse of antimyeloperoxidase antibodies-associated vasculitis
AU - Yamaguchi, Makoto
AU - Ando, Masahiko
AU - Katsuno, Takayuki
AU - Tsuboi, Naotake
AU - Maruyama, Shoichi
N1 - Funding Information:
From the *Department of Nephrology, Yokkaichi Municipal Hospital, Yokkaichi; and †Center for Advanced Medicine and Clinical Research, Nagoya Uni-versity Hospital, Nagoya; and ‡Department of Nephrology, Nagoya Uni-versity Graduate School of Medicine, Nagoya, Japan. This study was supported in part by a Grant-in-Aid for Progressive Renal Diseases Research, Research on Rare and Intractable Disease, from the Ministry of Health, Labor, and Welfare of Japan. Funding organizations had no role in collection, interpretation, or reporting of data. The authors declare no conflict of interest. The study protocol and consent procedure were approved by all participating institutional review boards. Consent was not required because of the use of anonymous linked data. Author Contributions: conception and design of experiments: M.Y., M.A., N.T., and S.M.; completion of experiments: M.Y., M.A., and T.K.; data analysis: M.Y. and M.A.; involvement in provision of reagents/materials/analysis tools: M.Y. and M.A.; writing of the paper: M.Y., M.A., and S.M. Correspondence: Shoichi Maruyama, MD, PhD, Department of Nephrology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. E‐mail: marus@med.nagoya-u.ac.jp. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 1076-1608 DOI: 10.1097/RHU.0000000000000737
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Background/Objective Several studies have identified predictors of relapse in antineutrophil cytoplasmic antibody-associated small-vessel vasculitis. However, the role of smoking as a risk factor of relapse has not been elucidated. Therefore, this study aimed to evaluate whether a history of smoking is a dose-dependent independent risk factor for antineutrophil cytoplasmic antibody-associated small-vessel vasculitis relapse. Methods This multicenter retrospective cohort study included 122 patients with granulomatosis with polyangiitis and microscopic polyangiitis (MPA) from 9 nephrology centers in Japan. Dose-response relationships between cigarette smoking and outcomes were assessed using multivariate Cox proportional hazards models, adjusted for clinically relevant factors. The primary outcome was the time from remission to first relapse. Results During the observation period (median, 41 months; interquartile range, 23-66 months), 118 (95.8%) and 34 (21.7%) patients experienced at least 1 remission and 1 relapse, respectively. A log-rank test showed that smoking was significantly associated with relapse (p = 0.003). Multivariate Cox proportional hazards models found current smoking to be associated with relapse (adjusted hazard ratio, 7.48; 95% confidence interval, 2.73-21.0). An association between the risk of relapse and cumulative pack-years of smoking was also noted (p = 0.004). Smoking, however, was not associated with remission. Conclusions Smoking is a significant and dose-dependent risk factor for relapse of MPA. All patients with MPA who smoke should be encouraged to quit.
AB - Background/Objective Several studies have identified predictors of relapse in antineutrophil cytoplasmic antibody-associated small-vessel vasculitis. However, the role of smoking as a risk factor of relapse has not been elucidated. Therefore, this study aimed to evaluate whether a history of smoking is a dose-dependent independent risk factor for antineutrophil cytoplasmic antibody-associated small-vessel vasculitis relapse. Methods This multicenter retrospective cohort study included 122 patients with granulomatosis with polyangiitis and microscopic polyangiitis (MPA) from 9 nephrology centers in Japan. Dose-response relationships between cigarette smoking and outcomes were assessed using multivariate Cox proportional hazards models, adjusted for clinically relevant factors. The primary outcome was the time from remission to first relapse. Results During the observation period (median, 41 months; interquartile range, 23-66 months), 118 (95.8%) and 34 (21.7%) patients experienced at least 1 remission and 1 relapse, respectively. A log-rank test showed that smoking was significantly associated with relapse (p = 0.003). Multivariate Cox proportional hazards models found current smoking to be associated with relapse (adjusted hazard ratio, 7.48; 95% confidence interval, 2.73-21.0). An association between the risk of relapse and cumulative pack-years of smoking was also noted (p = 0.004). Smoking, however, was not associated with remission. Conclusions Smoking is a significant and dose-dependent risk factor for relapse of MPA. All patients with MPA who smoke should be encouraged to quit.
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U2 - 10.1097/RHU.0000000000000737
DO - 10.1097/RHU.0000000000000737
M3 - Article
C2 - 29667942
AN - SCOPUS:85054335747
VL - 24
SP - 361
EP - 367
JO - Journal of Clinical Rheumatology
JF - Journal of Clinical Rheumatology
SN - 1076-1608
IS - 7
ER -