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

研究成果: Article査読

17 被引用数 (Scopus)

抄録

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.

本文言語English
ページ(範囲)1853-1860
ページ数8
ジャーナルJournal of Rheumatology
42
10
DOI
出版ステータスPublished - 01-10-2015
外部発表はい

All Science Journal Classification (ASJC) codes

  • リウマチ学
  • 免疫アレルギー学
  • 免疫学

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