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Association between renal-limited vasculitis and relapse of antineutrophil cytoplasmic antibody-associated vasculitis: A single-center retrospective cohort study in Japan
BACKGROUND: Several previous studies have evaluated the predictors of relapse in antineutrophil cytoplasmic antibody-associated vasculitis. Nonetheless, the association between renal-limited vasculitis and relapse has not been evaluated. OBJECTIVE: To assess the association between renal-limited vas...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9522015/ https://www.ncbi.nlm.nih.gov/pubmed/36174007 http://dx.doi.org/10.1371/journal.pone.0274483 |
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author | Yamaguchi, Makoto Ito, Mayumi Sugiyama, Hirokazu Iwagaitsu, Shiho Nobata, Hironobu Kinashi, Hiroshi Katsuno, Takayuki Ando, Masahiko Kubo, Yoko Banno, Shogo Ito, Yasuhiko Ishimoto, Takuji |
author_facet | Yamaguchi, Makoto Ito, Mayumi Sugiyama, Hirokazu Iwagaitsu, Shiho Nobata, Hironobu Kinashi, Hiroshi Katsuno, Takayuki Ando, Masahiko Kubo, Yoko Banno, Shogo Ito, Yasuhiko Ishimoto, Takuji |
author_sort | Yamaguchi, Makoto |
collection | PubMed |
description | BACKGROUND: Several previous studies have evaluated the predictors of relapse in antineutrophil cytoplasmic antibody-associated vasculitis. Nonetheless, the association between renal-limited vasculitis and relapse has not been evaluated. OBJECTIVE: To assess the association between renal-limited vasculitis and the incidence of relapse in Japan among patients with microscopic polyangiitis/renal-limited vasculitis. METHODS: This retrospective cohort study included consecutive patients in remission at 6 months, with renal-limited vasculitis (n = 24, renal-limited vasculitis group) and microscopic polyangiitis with renal and extra-renal involvement (n = 56, non-renal-limited vasculitis group) between 2004 and 2020. RESULTS: During the median follow-up period of 35 (range, 15‒57) months, 28 (35.0%) patients had a relapse. Multivariable Cox proportional hazards models revealed that the lower estimated glomerular filtration rate (per -10 mL/min/1.73 m(2); adjusted hazard ratio = 0.87, 95% confidence interval: 0.76–0.99; P = 0.043), renal-limited vasculitis (adjusted hazard ratio = 0.23, 95% confidence interval: 0.08–0.68; P = 0.008), and glucocorticoid combined with intravenous cyclophosphamide or rituximab (adjusted HR = 0.32, 95% CI: 0.11–0.96; P = 0.042) were associated with a decreased risk of relapse. Glucocorticoid dose during the observation period was lower in the renal-limited vasculitis group than in the non-renal-limited vasculitis group. CONCLUSIONS: Renal-limited vasculitis was associated with a lower risk of relapse than non-renal-limited vasculitis. Our data may contribute to the development of optimal management for renal-limited vasculitis, which may assist in minimizing the adverse effects of immunosuppressive therapy. |
format | Online Article Text |
id | pubmed-9522015 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-95220152022-09-30 Association between renal-limited vasculitis and relapse of antineutrophil cytoplasmic antibody-associated vasculitis: A single-center retrospective cohort study in Japan Yamaguchi, Makoto Ito, Mayumi Sugiyama, Hirokazu Iwagaitsu, Shiho Nobata, Hironobu Kinashi, Hiroshi Katsuno, Takayuki Ando, Masahiko Kubo, Yoko Banno, Shogo Ito, Yasuhiko Ishimoto, Takuji PLoS One Research Article BACKGROUND: Several previous studies have evaluated the predictors of relapse in antineutrophil cytoplasmic antibody-associated vasculitis. Nonetheless, the association between renal-limited vasculitis and relapse has not been evaluated. OBJECTIVE: To assess the association between renal-limited vasculitis and the incidence of relapse in Japan among patients with microscopic polyangiitis/renal-limited vasculitis. METHODS: This retrospective cohort study included consecutive patients in remission at 6 months, with renal-limited vasculitis (n = 24, renal-limited vasculitis group) and microscopic polyangiitis with renal and extra-renal involvement (n = 56, non-renal-limited vasculitis group) between 2004 and 2020. RESULTS: During the median follow-up period of 35 (range, 15‒57) months, 28 (35.0%) patients had a relapse. Multivariable Cox proportional hazards models revealed that the lower estimated glomerular filtration rate (per -10 mL/min/1.73 m(2); adjusted hazard ratio = 0.87, 95% confidence interval: 0.76–0.99; P = 0.043), renal-limited vasculitis (adjusted hazard ratio = 0.23, 95% confidence interval: 0.08–0.68; P = 0.008), and glucocorticoid combined with intravenous cyclophosphamide or rituximab (adjusted HR = 0.32, 95% CI: 0.11–0.96; P = 0.042) were associated with a decreased risk of relapse. Glucocorticoid dose during the observation period was lower in the renal-limited vasculitis group than in the non-renal-limited vasculitis group. CONCLUSIONS: Renal-limited vasculitis was associated with a lower risk of relapse than non-renal-limited vasculitis. Our data may contribute to the development of optimal management for renal-limited vasculitis, which may assist in minimizing the adverse effects of immunosuppressive therapy. Public Library of Science 2022-09-29 /pmc/articles/PMC9522015/ /pubmed/36174007 http://dx.doi.org/10.1371/journal.pone.0274483 Text en © 2022 Yamaguchi et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Yamaguchi, Makoto Ito, Mayumi Sugiyama, Hirokazu Iwagaitsu, Shiho Nobata, Hironobu Kinashi, Hiroshi Katsuno, Takayuki Ando, Masahiko Kubo, Yoko Banno, Shogo Ito, Yasuhiko Ishimoto, Takuji Association between renal-limited vasculitis and relapse of antineutrophil cytoplasmic antibody-associated vasculitis: A single-center retrospective cohort study in Japan |
title | Association between renal-limited vasculitis and relapse of antineutrophil cytoplasmic antibody-associated vasculitis: A single-center retrospective cohort study in Japan |
title_full | Association between renal-limited vasculitis and relapse of antineutrophil cytoplasmic antibody-associated vasculitis: A single-center retrospective cohort study in Japan |
title_fullStr | Association between renal-limited vasculitis and relapse of antineutrophil cytoplasmic antibody-associated vasculitis: A single-center retrospective cohort study in Japan |
title_full_unstemmed | Association between renal-limited vasculitis and relapse of antineutrophil cytoplasmic antibody-associated vasculitis: A single-center retrospective cohort study in Japan |
title_short | Association between renal-limited vasculitis and relapse of antineutrophil cytoplasmic antibody-associated vasculitis: A single-center retrospective cohort study in Japan |
title_sort | association between renal-limited vasculitis and relapse of antineutrophil cytoplasmic antibody-associated vasculitis: a single-center retrospective cohort study in japan |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9522015/ https://www.ncbi.nlm.nih.gov/pubmed/36174007 http://dx.doi.org/10.1371/journal.pone.0274483 |
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