Association between renal-limited vasculitis and relapse of antineutrophil cytoplasmic antibody-associated vasculitis: A single-center retrospective cohort study in Japan.
<h4>Background</h4>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.<h4>Objective</h4>To assess the...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0274483 |
| _version_ | 1797997266315771904 |
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| author | Makoto Yamaguchi Mayumi Ito Hirokazu Sugiyama Shiho Iwagaitsu Hironobu Nobata Hiroshi Kinashi Takayuki Katsuno Masahiko Ando Yoko Kubo Shogo Banno Yasuhiko Ito Takuji Ishimoto |
| author_facet | Makoto Yamaguchi Mayumi Ito Hirokazu Sugiyama Shiho Iwagaitsu Hironobu Nobata Hiroshi Kinashi Takayuki Katsuno Masahiko Ando Yoko Kubo Shogo Banno Yasuhiko Ito Takuji Ishimoto |
| author_sort | Makoto Yamaguchi |
| collection | DOAJ |
| description | <h4>Background</h4>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.<h4>Objective</h4>To assess the association between renal-limited vasculitis and the incidence of relapse in Japan among patients with microscopic polyangiitis/renal-limited vasculitis.<h4>Methods</h4>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.<h4>Results</h4>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 m2; 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.<h4>Conclusions</h4>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. |
| first_indexed | 2024-04-11T10:29:11Z |
| format | Article |
| id | doaj.art-62ffbef1099e4da6b76a8486079bc25c |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T10:29:11Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-62ffbef1099e4da6b76a8486079bc25c2022-12-22T04:29:28ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01179e027448310.1371/journal.pone.0274483Association between renal-limited vasculitis and relapse of antineutrophil cytoplasmic antibody-associated vasculitis: A single-center retrospective cohort study in Japan.Makoto YamaguchiMayumi ItoHirokazu SugiyamaShiho IwagaitsuHironobu NobataHiroshi KinashiTakayuki KatsunoMasahiko AndoYoko KuboShogo BannoYasuhiko ItoTakuji Ishimoto<h4>Background</h4>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.<h4>Objective</h4>To assess the association between renal-limited vasculitis and the incidence of relapse in Japan among patients with microscopic polyangiitis/renal-limited vasculitis.<h4>Methods</h4>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.<h4>Results</h4>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 m2; 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.<h4>Conclusions</h4>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.https://doi.org/10.1371/journal.pone.0274483 |
| spellingShingle | Makoto Yamaguchi Mayumi Ito Hirokazu Sugiyama Shiho Iwagaitsu Hironobu Nobata Hiroshi Kinashi Takayuki Katsuno Masahiko Ando Yoko Kubo Shogo Banno Yasuhiko Ito Takuji Ishimoto Association between renal-limited vasculitis and relapse of antineutrophil cytoplasmic antibody-associated vasculitis: A single-center retrospective cohort study in Japan. PLoS ONE |
| 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 |
| url | https://doi.org/10.1371/journal.pone.0274483 |
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