RT Journal Article
SR Electronic
T1 Comparison of Phenotype and Outcome in Microscopic Polyangiitis Between Europe and Japan
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 325
OP 333
DO 10.3899/jrheum.130602
VO 41
IS 2
A1 Shunsuke Furuta
A1 Afzal N. Chaudhry
A1 Yoshitomo Hamano
A1 Shouichi Fujimoto
A1 Hiroko Nagafuchi
A1 Hirofumi Makino
A1 Seiichi Matsuo
A1 Shoichi Ozaki
A1 Tomomi Endo
A1 Eri Muso
A1 Chiharu Ito
A1 Eiji Kusano
A1 Mieko Yamagata
A1 Kei Ikeda
A1 Daisuke Kashiwakuma
A1 Itsuo Iwamoto
A1 Kerstin Westman
A1 David Jayne
YR 2014
UL http://www.jrheum.org/content/41/2/325.abstract
AB Objective. There are differences between Europe and Japan in the incidence and antineutrophil cytoplasmic antibody (ANCA) serotype of patients with microscopic polyangiitis (MPA). However, differences in phenotype or outcome have not been explored. We aimed to identify differences in phenotype and outcome of MPA between Europe and Japan. Methods. Sequential cohorts of patients with MPA and renal limited vasculitis were collected from European and Japanese centers (n = 147 and n = 312, respectively). Trial databases from the European Vasculitis Society and the Japanese patients with Myeloperoxidase (MPO)-ANCA-Associated Vasculitis (JMAAV) trial were studied (n = 254 and n = 48, respectively). We evaluated baseline characteristics including ANCA status and organ involvement, treatment, survival, and renal survival. Differences in survival and renal survival were studied using multivariate analysis. Results. The non-trial cohorts showed patients with MPA in Japan had a higher age at onset, more frequent MPO-ANCA positivity, lower serum creatinine, and more frequent interstitial pneumonitis than those in Europe (all p < 0.01). Comparisons between the trial databases demonstrated similar results. Cumulative patient survival and renal survival rates were not different between Europe and Japan (p = 0.71 and p = 0.38, respectively). Multivariate analysis identified age at onset, serum creatinine, gastrointestinal, and respiratory involvement as factors with higher risk of death. For endstage renal failure, serum creatinine and use of plasma exchange were identified as factors with higher risk, and immunosuppressant use as lower risk factors. Conclusion. Phenotypes in patients with MPA were different between Europe and Japan. However, the outcomes of patient survival and renal survival were similar.