PMID- 33585954
OWN - NLM
STAT- MEDLINE
DCOM- 20211115
LR  - 20211115
IS  - 1437-160X (Electronic)
IS  - 0172-8172 (Linking)
VI  - 41
IP  - 5
DP  - 2021 May
TI  - Antibody subtypes and titers predict clinical outcomes in ANCA-associated 
      vasculitis.
PG  - 965-972
LID - 10.1007/s00296-021-04802-w [doi]
AB  - The objective of this study is to evaluate the association between antineutrophil 
      cytoplasmic autoantibody (ANCA) subtype and ANCA titers on clinical outcomes and 
      disease activity among a cohort of patients from Central Appalachia diagnosed 
      with ANCA-associated vasculitis (AAV) over a 3-decade period. This is a 
      retrospective chart review of all patients diagnosed with AAV. ANCA subtypes 
      (myeloperoxidase (MPO) and proteinase 3 (PR3)) and titers at the time of 
      diagnosis and at the time of relapse or last follow-up were evaluated along with 
      patient outcomes. Outcomes of interest included relapse, development of end-stage 
      renal disease (ESRD) and mortality. Sensitivity analysis and multivariable 
      analysis were performed. Of the 202 patients, 111 patients were MPO-ANCA positive 
      and 91 patients were PR3-ANCA positive. Relapse was more frequent among patients 
      with PR3-ANCA compared to MPO-ANCA (35% vs 12%, p < 0.001). In both ANCA 
      subgroups, the strongest predictor of relapse was an increase in titers prior to 
      relapse, HR 8.1 (95% CI 1.6-40), p 0.009. Patients who achieved serological 
      remission had a lower risk of ESRD [sub-HR 0.31 (95% CI 0.11-0.89)] and mortality 
      [HR (95% CI) 0.24 (0.07-0.7)]. PR3-ANCA was associated with higher risk of ESRD 
      [sub-HR 3.1 (95% CI 1.1-8.5)]. There was no difference in mortality between 
      patients with MPO-ANCA and PR3-ANCA. Our study supports the use of both ANCA 
      subtypes and titer levels for predicting clinical outcomes in patients receiving 
      treatment for AAV. Monitoring of ANCA antibody titers may be useful since both 
      serological remission and increase in titers provide prognostic information.
FAU - Aljuhani, Muhammad
AU  - Aljuhani M
AD  - Department of Nephrology, University of Minnesota, Minneapolis, MN, USA.
AD  - Section of Nephrology, Department of Medicine, West Virginia University School of 
      Medicine, Morgantown, WV, USA.
FAU - Makati, Devan
AU  - Makati D
AD  - Section of Nephrology, Department of Medicine, West Virginia University School of 
      Medicine, Morgantown, WV, USA.
FAU - Hoff, Abigail
AU  - Hoff A
AUID- ORCID: 0000-0002-8497-451X
AD  - Department of Pharmacy, West Virginia University School of Pharmacy, Morgantown, 
      WV, USA.
FAU - Thompson, Jesse
AU  - Thompson J
AD  - Department of Medicine, West Virginia University School of Medicine, Morgantown, 
      WV, USA.
FAU - Pellegrino, Bethany
AU  - Pellegrino B
AUID- ORCID: 0000-0003-3688-9377
AD  - Section of Nephrology, Department of Medicine, West Virginia University School of 
      Medicine, Morgantown, WV, USA.
FAU - Shawwa, Khaled
AU  - Shawwa K
AUID- ORCID: 0000-0001-8849-5244
AD  - Section of Nephrology, Department of Medicine, West Virginia University School of 
      Medicine, Morgantown, WV, USA.
FAU - Schmidt, Rebecca
AU  - Schmidt R
AUID- ORCID: 0000-0001-5232-5083
AD  - Section of Nephrology, Department of Medicine, West Virginia University School of 
      Medicine, Morgantown, WV, USA.
FAU - Kannabhiran, Dinesh
AU  - Kannabhiran D
AUID- ORCID: 0000-0003-1686-827X
AD  - Section of Nephrology, Department of Medicine, West Virginia University School of 
      Medicine, Morgantown, WV, USA. dk0053@hsc.wvu.edu.
LA  - eng
PT  - Journal Article
DEP - 20210213
PL  - Germany
TA  - Rheumatol Int
JT  - Rheumatology international
JID - 8206885
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
RN  - 0 (Biomarkers)
RN  - EC 1.11.1.7 (MPO protein, human)
RN  - EC 1.11.1.7 (Peroxidase)
RN  - EC 3.4.21.76 (Myeloblastin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated 
      Vasculitis/classification/complications/*immunology/mortality
MH  - Antibodies, Antineutrophil Cytoplasmic/*blood/immunology
MH  - Biomarkers/blood
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Kidney Failure, Chronic/etiology
MH  - Male
MH  - Middle Aged
MH  - Myeloblastin/*blood/immunology
MH  - Peroxidase/*blood/immunology
MH  - Recurrence
MH  - Retrospective Studies
OTO - NOTNLM
OT  - ANCA subtypes
OT  - ANCA titers
OT  - ANCA-associated vasculitis
OT  - Clinical outcomes
OT  - End-stage renal disease
OT  - Mortality
OT  - Relapse
OT  - Serological remission
EDAT- 2021/02/16 06:00
MHDA- 2021/11/16 06:00
CRDT- 2021/02/15 06:13
PHST- 2020/12/01 00:00 [received]
PHST- 2021/01/27 00:00 [accepted]
PHST- 2021/02/16 06:00 [pubmed]
PHST- 2021/11/16 06:00 [medline]
PHST- 2021/02/15 06:13 [entrez]
AID - 10.1007/s00296-021-04802-w [pii]
AID - 10.1007/s00296-021-04802-w [doi]
PST - ppublish
SO  - Rheumatol Int. 2021 May;41(5):965-972. doi: 10.1007/s00296-021-04802-w. Epub 2021 
      Feb 13.