PMID- 27696762
OWN - NLM
STAT- MEDLINE
DCOM- 20170829
LR  - 20181113
IS  - 2151-4658 (Electronic)
IS  - 2151-464X (Print)
IS  - 2151-464X (Linking)
VI  - 69
IP  - 7
DP  - 2017 Jul
TI  - Effect of Disease Activity, Glucocorticoid Exposure, and Rituximab on Body 
      Composition During Induction Treatment of Antineutrophil Cytoplasmic 
      Antibody-Associated Vasculitis.
PG  - 1004-1010
LID - 10.1002/acr.23099 [doi]
AB  - OBJECTIVE: We investigated the relationships between glucocorticoid use, disease 
      activity, and changes in body mass index (BMI) in patients with antineutrophil 
      cytoplasmic antibody-associated vasculitis (AAV). METHODS: We analyzed AAV 
      patients enrolled in the Rituximab in AAV trial. Glucocorticoid use, BMI, and 
      disease activity were measured regularly during the trial period. We performed 
      mixed-effects regressions to examine the associations of time-dependent 
      cumulative average glucocorticoid use and disease activity with changes in BMI 
      over time, while adjusting for potential confounders. RESULTS: The mean +/- SD 
      baseline BMI of the 197 patients enrolled was 28.8 +/- 6.3 kg/m(2) . Patients with 
      newly diagnosed AAV tended to have a lower mean +/- SD BMI than those with 
      relapsing disease (28.0 +/- 5.7 kg/m(2) versus 29.6 +/- 6.8 kg/m(2) ) and higher 
      disease activity (mean +/- SD Birmingham Vasculitis Activity Score for Wegener's 
      Granulomatosis 8.7 +/- 3.3 versus 7.4 +/- 2.7). The most significant change in BMI 
      occurred during the first 6 months of the trial (mean +/- SD increase of 1.1 +/- 2.2 
      kg/m(2) ; P < 0.0001). Disease activity improvement, glucocorticoid exposure, and 
      randomization to rituximab were each independently associated with an increase in 
      BMI (P < 0.001 for all analyses). CONCLUSION: Our findings suggest that changes 
      in BMI, as well as glucocorticoid exposure, are independently associated with 
      improvements in disease activity in AAV. Rituximab may also have effects on BMI 
      independent of its impact on disease activity.
CI  - (c) 2016, American College of Rheumatology.
FAU - Wallace, Zachary S
AU  - Wallace ZS
AD  - Massachusetts General Hospital, Boston.
FAU - Miloslavsky, Eli M
AU  - Miloslavsky EM
AD  - Massachusetts General Hospital, Boston.
FAU - Cascino, Matthew
AU  - Cascino M
AD  - Massachusetts General Hospital, Boston.
FAU - Unizony, Sebastian H
AU  - Unizony SH
AD  - Massachusetts General Hospital, Boston.
FAU - Lu, Na
AU  - Lu N
AD  - Massachusetts General Hospital, Boston.
FAU - Hoffman, Gary S
AU  - Hoffman GS
AD  - Cleveland Clinic Foundation, Cleveland, Ohio.
FAU - Kallenberg, Cees G M
AU  - Kallenberg CGM
AD  - Universiteit Groningen, Groningen, The Netherlands.
FAU - Langford, Carol A
AU  - Langford CA
AD  - Cleveland Clinic Foundation, Cleveland, Ohio.
FAU - Merkel, Peter A
AU  - Merkel PA
AD  - University of Pennsylvania, Philadelphia.
FAU - Monach, Paul A
AU  - Monach PA
AD  - Boston Medical Center, Boston University, Boston, Massachusetts.
FAU - Seo, Philip
AU  - Seo P
AD  - Johns Hopkins Vasculitis Center, Johns Hopkins University, Baltimore, Maryland.
FAU - Spiera, Robert
AU  - Spiera R
AD  - Hospital for Special Surgery, New York, New York.
FAU - St Clair, E William
AU  - St Clair EW
AD  - Duke University, Durham, North Carolina.
FAU - Specks, Ulrich
AU  - Specks U
AD  - Mayo Clinic, Rochester, Minnesota.
FAU - Brunetta, Paul
AU  - Brunetta P
AD  - Genentech, San Francisco, California.
FAU - Choi, Hyon K
AU  - Choi HK
AD  - Massachusetts General Hospital, Boston.
FAU - Stone, John H
AU  - Stone JH
AD  - Massachusetts General Hospital, Boston.
LA  - eng
SI  - ClinicalTrials.gov/NCT00104299
GR  - N01AI15416/AI/NIAID NIH HHS/United States
GR  - UL1 RR025005/RR/NCRR NIH HHS/United States
GR  - K23 AR052820/AR/NIAMS NIH HHS/United States
GR  - M01 RR000533/RR/NCRR NIH HHS/United States
GR  - UL1 RR025771/RR/NCRR NIH HHS/United States
GR  - K24 AR002224/AR/NIAMS NIH HHS/United States
GR  - UL1 TR000439/TR/NCATS NIH HHS/United States
GR  - K24 AR049185/AR/NIAMS NIH HHS/United States
GR  - UL1 RR024150/RR/NCRR NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arthritis Care Res (Hoboken)
JT  - Arthritis care & research
JID - 101518086
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Glucocorticoids)
RN  - 4F4X42SYQ6 (Rituximab)
SB  - IM
MH  - Administration, Intravenous
MH  - Adult
MH  - Aged
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/blood/diagnosis/*drug 
      therapy
MH  - Antibodies, Antineutrophil Cytoplasmic/blood
MH  - Antirheumatic Agents/*administration & dosage/adverse effects
MH  - Body Composition/*drug effects/physiology
MH  - *Disease Progression
MH  - Drug Therapy, Combination
MH  - Female
MH  - Glucocorticoids/*administration & dosage/adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Remission Induction/methods
MH  - Rituximab/*administration & dosage/adverse effects
MH  - Treatment Outcome
PMC - PMC5611860
MID - NIHMS884957
EDAT- 2016/10/04 06:00
MHDA- 2017/08/30 06:00
PMCR- 2017/09/25
CRDT- 2016/10/04 06:00
PHST- 2016/03/15 00:00 [received]
PHST- 2016/08/03 00:00 [revised]
PHST- 2016/09/20 00:00 [accepted]
PHST- 2016/10/04 06:00 [pubmed]
PHST- 2017/08/30 06:00 [medline]
PHST- 2016/10/04 06:00 [entrez]
PHST- 2017/09/25 00:00 [pmc-release]
AID - 10.1002/acr.23099 [doi]
PST - ppublish
SO  - Arthritis Care Res (Hoboken). 2017 Jul;69(7):1004-1010. doi: 10.1002/acr.23099.