PMID- 21898055
OWN - NLM
STAT- MEDLINE
DCOM- 20130220
LR  - 20221207
IS  - 1437-160X (Electronic)
IS  - 0172-8172 (Linking)
VI  - 32
IP  - 10
DP  - 2012 Oct
TI  - Evaluation of weekly-reduction regimen of glucocorticoids in combination with 
      cyclophosphamide for anti-neutrophil cytoplasmic antibody (ANCA)-associated 
      vasculitis in Japanese patients.
PG  - 2999-3005
AB  - The current therapeutic regimen recommended by the European League against 
      Rheumatism (EULAR) for anti-neutrophil cytoplasmic antibody-associated vasculitis 
      (AAV) is continuation of initially administered doses of glucocorticoids (GCs) in 
      combination with cyclophosphamide (CYC) for 1 month followed by gradual tapering. 
      Considering the adverse effects of GCs, another tapering regimen of GCs with CYC, 
      which was characterized by tapering GCs weekly, was reported by the British 
      Society of Rheumatology (weekly-reduction regimen). The aim of the present study 
      is to evaluate the safety and efficacy of this weekly-reduction regimen for 
      Japanese AAV patients in comparison with the monthly-reduction regimen 
      recommended by the EULAR. We retrospectively reviewed medical records of adult 
      patients newly diagnosed with AAV during the period from April 2000 to December 
      2010. The outcome measures were rates of remission, relapse, infection, and 
      GC-induced diabetes mellitus during the first 12 months. Clinical data in the two 
      groups and categorial variables with a possible relation to the outcomes were 
      compared by using the t test and chi-square test, respectively. Twenty-four 
      patients were enrolled in our study. All of the patients achieved remission, and 
      the rates of relapse during the first 12 months were not statistically different 
      between the two groups (P = 0.16). Patients treated with the weekly-reduction 
      regimen were less liable to have infection (P = 0.03) and impaired glucose 
      tolerance (P = 0.017), compared with those treated with the monthly-reduction 
      regimen. A therapeutic strategy using the weekly-reduction regimen of GCs would 
      be effective and would have fewer side effects than the monthly-reduction 
      regimen.
FAU - Matsumoto, Yoshinori
AU  - Matsumoto Y
AD  - Department of Medicine and Clinical Science, Okayama University Graduate School 
      of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kitaku, 
      Okayama City 700-8558, Japan. yossy.m0629@nifty.com
FAU - Sada, Ken-Ei
AU  - Sada KE
FAU - Otsuka, Fumio
AU  - Otsuka F
FAU - Takano, Mariko
AU  - Takano M
FAU - Toyota, Noriko
AU  - Toyota N
FAU - Sugiyama, Koichi
AU  - Sugiyama K
FAU - Wakabayashi, Hiroshi
AU  - Wakabayashi H
FAU - Kawabata, Tomoko
AU  - Kawabata T
FAU - Makino, Hirofumi
AU  - Makino H
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110907
PL  - Germany
TA  - Rheumatol Int
JT  - Rheumatology international
JID - 8206885
RN  - 0 (Glucocorticoids)
RN  - 0 (Immunosuppressive Agents)
RN  - 8N3DW7272P (Cyclophosphamide)
SB  - IM
MH  - Aged
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/blood/*drug 
      therapy/ethnology/immunology
MH  - Asian People
MH  - Chi-Square Distribution
MH  - Communicable Diseases/etiology
MH  - Cyclophosphamide/*administration & dosage/adverse effects
MH  - Diabetes Mellitus/chemically induced
MH  - Drug Therapy, Combination
MH  - Female
MH  - Glucocorticoids/*administration & dosage/adverse effects
MH  - Humans
MH  - Immunosuppressive Agents/*administration & dosage/adverse effects
MH  - Japan/epidemiology
MH  - Male
MH  - Recurrence
MH  - Remission Induction
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2011/09/08 06:00
MHDA- 2013/02/21 06:00
CRDT- 2011/09/08 06:00
PHST- 2011/05/08 00:00 [received]
PHST- 2011/08/22 00:00 [accepted]
PHST- 2011/09/08 06:00 [entrez]
PHST- 2011/09/08 06:00 [pubmed]
PHST- 2013/02/21 06:00 [medline]
AID - 10.1007/s00296-011-2136-z [doi]
PST - ppublish
SO  - Rheumatol Int. 2012 Oct;32(10):2999-3005. doi: 10.1007/s00296-011-2136-z. Epub 
      2011 Sep 7.