RT Journal Article
SR Electronic
T1 Increase of Antimyeloperoxidase Antineutrophil Cytoplasmic Antibody (ANCA) in Patients with Renal ANCA-associated Vasculitis: Association with Risk to Relapse
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.141622
DO 10.3899/jrheum.141622
A1 Makoto Yamaguchi
A1 Masahiko Ando
A1 Sawako Kato
A1 Takayuki Katsuno
A1 Noritoshi Kato
A1 Tomoki Kosugi
A1 Waichi Sato
A1 Naotake Tsuboi
A1 Yoshinari Yasuda
A1 Masashi Mizuno
A1 Yasuhiko Ito
A1 Seiichi Matsuo
A1 Shoichi Maruyama
YR 2015
UL http://www.jrheum.org/content/early/2015/09/10/jrheum.141622.abstract
AB Objective The diagnostic values of antiproteinase 3 and antimyeloperoxidase tests using antineutrophil 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.