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Plasmapheresis for systemic vasculitis

Systemic vasculitides include a variety of, and numerous diseases. In 2012, the International CHAPEL HILL Consensus Conference (CHCC2012) led to a major reorganization of the classification of vasculitis, and this is still in wide use today. Although the results of plasmapheresis for individual dise...

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Autores principales: Fukuoka, Kazuhito, Kishimoto, Mitsumasa, Kawakami, Takahisa, Komagata, Yosinori, Kaname, Shinya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9311821/
https://www.ncbi.nlm.nih.gov/pubmed/35247230
http://dx.doi.org/10.1111/1744-9987.13829
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author Fukuoka, Kazuhito
Kishimoto, Mitsumasa
Kawakami, Takahisa
Komagata, Yosinori
Kaname, Shinya
author_facet Fukuoka, Kazuhito
Kishimoto, Mitsumasa
Kawakami, Takahisa
Komagata, Yosinori
Kaname, Shinya
author_sort Fukuoka, Kazuhito
collection PubMed
description Systemic vasculitides include a variety of, and numerous diseases. In 2012, the International CHAPEL HILL Consensus Conference (CHCC2012) led to a major reorganization of the classification of vasculitis, and this is still in wide use today. Although the results of plasmapheresis for individual diseases have been sometimes shown, there are few systematic reviews that discuss the effects along with vasculitis classification. Therefore, we will discuss the efficacy and the latest evidence for each vasculitis according to the CHCC 2012 classification in this review. This review provides a comprehensive overview of the estimation of plasmapheresis in each of the vasculitides, with a particular focus on small vasculitides, which have recently discussed frequently. For some time now, plasma exchange therapy (PEX) has been frequently used and is expected to be effective in some diseases, most of which are included in small vessel vasculitides. In particular, data showing efficacy have been accumulated for immune complex vasculitis, and the recommendation seems to be high. For instance, anti‐GBM nephritis, concomitant use of PEX is essential and strongly recommended. On the other hand, for ANCA‐related vasculitis among small vessel vasculitis, RCTs have recently shown negative results. In particular, the PEXIVAS trial statistically showed that PEX has no potential to reduce the mortality and renal death in AAV, but the ASFA, ACR, and KDIGO guidelines following this trial all regard PEX as salvage therapy or selective treatment for severe cases. As plasmapheresis is often performed in combination with other therapies, it is difficult to evaluate to clarify its efficacy on its own, and this predisposition may be pronounced in vasculitis, a rare disease. Although statistically significant differences are not apparent, the diseases that show a trend toward efficacy may possibly include treatment‐sensitive subgroups. Further analysis is expected in the future.
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spelling pubmed-93118212022-07-30 Plasmapheresis for systemic vasculitis Fukuoka, Kazuhito Kishimoto, Mitsumasa Kawakami, Takahisa Komagata, Yosinori Kaname, Shinya Ther Apher Dial Review Systemic vasculitides include a variety of, and numerous diseases. In 2012, the International CHAPEL HILL Consensus Conference (CHCC2012) led to a major reorganization of the classification of vasculitis, and this is still in wide use today. Although the results of plasmapheresis for individual diseases have been sometimes shown, there are few systematic reviews that discuss the effects along with vasculitis classification. Therefore, we will discuss the efficacy and the latest evidence for each vasculitis according to the CHCC 2012 classification in this review. This review provides a comprehensive overview of the estimation of plasmapheresis in each of the vasculitides, with a particular focus on small vasculitides, which have recently discussed frequently. For some time now, plasma exchange therapy (PEX) has been frequently used and is expected to be effective in some diseases, most of which are included in small vessel vasculitides. In particular, data showing efficacy have been accumulated for immune complex vasculitis, and the recommendation seems to be high. For instance, anti‐GBM nephritis, concomitant use of PEX is essential and strongly recommended. On the other hand, for ANCA‐related vasculitis among small vessel vasculitis, RCTs have recently shown negative results. In particular, the PEXIVAS trial statistically showed that PEX has no potential to reduce the mortality and renal death in AAV, but the ASFA, ACR, and KDIGO guidelines following this trial all regard PEX as salvage therapy or selective treatment for severe cases. As plasmapheresis is often performed in combination with other therapies, it is difficult to evaluate to clarify its efficacy on its own, and this predisposition may be pronounced in vasculitis, a rare disease. Although statistically significant differences are not apparent, the diseases that show a trend toward efficacy may possibly include treatment‐sensitive subgroups. Further analysis is expected in the future. John Wiley & Sons Australia, Ltd 2022-03-16 2022-06 /pmc/articles/PMC9311821/ /pubmed/35247230 http://dx.doi.org/10.1111/1744-9987.13829 Text en © 2022 The Authors. Therapeutic Apheresis and Dialysis published by John Wiley & Sons Australia, Ltd on behalf of International Society for Apheresis and Japanese Society for Apheresis. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Review
Fukuoka, Kazuhito
Kishimoto, Mitsumasa
Kawakami, Takahisa
Komagata, Yosinori
Kaname, Shinya
Plasmapheresis for systemic vasculitis
title Plasmapheresis for systemic vasculitis
title_full Plasmapheresis for systemic vasculitis
title_fullStr Plasmapheresis for systemic vasculitis
title_full_unstemmed Plasmapheresis for systemic vasculitis
title_short Plasmapheresis for systemic vasculitis
title_sort plasmapheresis for systemic vasculitis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9311821/
https://www.ncbi.nlm.nih.gov/pubmed/35247230
http://dx.doi.org/10.1111/1744-9987.13829
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