TY - JOUR
T1 - Risk factors associated with relapse in Japanese patients with microscopic polyangiitis
AU - Wada, Takashi
AU - Hara, Akinori
AU - Arimura, Yoshihiro
AU - Sada, Kenei
AU - Makino, Hirofumi
AU - Amano, Koichi
AU - Ito, Satoshi
AU - Usui, Joichi
AU - Kumagai, Shunichi
AU - Kobayashi, Shigeto
AU - Takasaki, Yoshinari
AU - Tanemoto, Kazuo
AU - Dobashi, Hiroaki
AU - Harigai, Masayoshi
AU - Fujii, Takao
AU - Fujimoto, Shouichi
AU - Homma, Sakae
AU - Muso, Eri
AU - Murakawa, Yohko
AU - Yamada, Hidehiro
AU - Yumura, Wako
AU - Yoshida, Masaharu
PY - 2012/3
Y1 - 2012/3
N2 - Objective. We retrospectively studied the risk factors associated with relapse during remission maintenance therapy for myeloperoxidase-antineutrophil cytoplasmic autoantibody (MPO-ANCA)-positive microscopic polyangiitis (MPA). Methods. Sixty-two patients diagnosed with MPA according to the European Medicines Agency classification algorithm during a 2-year period from January 1, 2005, to December 31, 2006, and who achieved remission after the first remission-induction therapy, were examined (registration no. UMIN000001785). Results. The patient group comprised 25 men and 37 women aged 70.0 ± 8.9 years. The mean observation period was 30.2 ± 15.9 months. The rate of relapse was 24.2% (15/62), and mean interval between remission and relapse was 16.9 ± 13.5 months. During maintenance therapy following remission, the risk of relapse increased when the reduction rate of prednisolone increased above 0.8 mg/month (OR 12.6, 95% CI 2.2-97.9). Proteinuria at the start of maintenance therapy (regression coefficient 1.991 ± 0.758, p < 0.05) and the change in red blood cell counts in urine during the period from the start of maintenance therapy to the final observation (regression coefficient 0.126 ± 0.040, p < 0.01) were identified as risk factors influencing the vasculitis damage index. Conclusion. In Japan, relapse of MPO-ANCA-positive MPA may be associated with the reduction rate of oral prednisolone administration during maintenance therapy. The Journal of Rheumatology
AB - Objective. We retrospectively studied the risk factors associated with relapse during remission maintenance therapy for myeloperoxidase-antineutrophil cytoplasmic autoantibody (MPO-ANCA)-positive microscopic polyangiitis (MPA). Methods. Sixty-two patients diagnosed with MPA according to the European Medicines Agency classification algorithm during a 2-year period from January 1, 2005, to December 31, 2006, and who achieved remission after the first remission-induction therapy, were examined (registration no. UMIN000001785). Results. The patient group comprised 25 men and 37 women aged 70.0 ± 8.9 years. The mean observation period was 30.2 ± 15.9 months. The rate of relapse was 24.2% (15/62), and mean interval between remission and relapse was 16.9 ± 13.5 months. During maintenance therapy following remission, the risk of relapse increased when the reduction rate of prednisolone increased above 0.8 mg/month (OR 12.6, 95% CI 2.2-97.9). Proteinuria at the start of maintenance therapy (regression coefficient 1.991 ± 0.758, p < 0.05) and the change in red blood cell counts in urine during the period from the start of maintenance therapy to the final observation (regression coefficient 0.126 ± 0.040, p < 0.01) were identified as risk factors influencing the vasculitis damage index. Conclusion. In Japan, relapse of MPO-ANCA-positive MPA may be associated with the reduction rate of oral prednisolone administration during maintenance therapy. The Journal of Rheumatology
KW - Antineutrophil cytoplasmic antibody
KW - Microscopic polyangiitis
KW - Relapse
KW - Risk factors
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U2 - 10.3899/jrheum.110705
DO - 10.3899/jrheum.110705
M3 - Article
C2 - 22174198
AN - SCOPUS:84857856555
SN - 0315-162X
VL - 39
SP - 545
EP - 551
JO - Journal of Rheumatology
JF - Journal of Rheumatology
IS - 3
ER -