PMID- 34384719
OWN - NLM
STAT- MEDLINE
DCOM- 20220223
LR  - 20220223
IS  - 1473-0502 (Print)
IS  - 1473-0502 (Linking)
VI  - 60
IP  - 6
DP  - 2021 Dec
TI  - Analyses of registry data of patients with anti-GBM and antineutrophil 
      cytoplasmatic antibody-associated (ANCA) vasculitis treated with or without 
      therapeutic apheresis.
PG  - 103227
LID - S1473-0502(21)00214-7 [pii]
LID - 10.1016/j.transci.2021.103227 [doi]
AB  - Therapeutic apheresis (TA) as a treatment for antibody-associated vasculitis 
      (AAV) was questioned by the PEXIVAS although the MEPEX study favored TA. The aim 
      of this study was to evaluate the efficacy of TA to improve renal function in 
      patients consecutively included in the WAA-apheresis registry versus patients not 
      treated with TA. MATERIALS AND METHODS: Included were 192 patients that suffered 
      from anti-glomerular basement membrane disease (anti-GBM, n = 28) and 
      antineutrophil cytoplasmic antibody-associated vasculitis of MPO or PR3 origin. 
      Of these 119 had performed TA and the other 73 had not performed TA for theses 
      diagnoses (CTRL). RESULTS: Elderly had an increased risk to die within 12 months 
      (p = 0.002). All 28 anti-GBM had renal involvement, 21 dialysis dependent. At 3 
      month nine (36 %) did not need dialysis. Baseline data regarding renal function 
      of AAV patients, subtype MPO and PR3, were worse in the TA groups than in CTRL. 
      Recovery out of dialysis was better for the PR3-TA group compared with 1) the 
      controls of MEPEX (RR 0.59, CI 0.43-0.80) and 2) the MPO-TA patients (RR 0.28, CI 
      0.12-0.68). The MPO-TA recovered similarly as the MEPEX-CTRL. Renal function 
      improved most for TA-patients from baseline during the first 3 months (MPO-TA and 
      PR3-TA) and stabilized thereafter and less for MPO-CTRL and PR3-CTRL. CONCLUSION: 
      PR3-TA patients seem to have best chances to get out of dialysis. PR3-TA and 
      MPO-TA improved residual renal function better than CTRL. The present study 
      recommends reconsiderations to use TA for AAV especially those with 
      PR3-vasculitis with severe renal vasculitis.
CI  - Copyright (c) 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.
FAU - Mortzell Henriksson, M
AU  - Mortzell Henriksson M
AD  - Umea University, Umea, Sweden.
FAU - Weiner, M
AU  - Weiner M
AD  - Department of Nephrology in Linkoping, and Department of Health, Medicine and 
      Caring Sciences, Linkoping University, Linkoping, Sweden.
FAU - Sperker, W
AU  - Sperker W
AD  - Umea University, Umea, Sweden.
FAU - Berlin, G
AU  - Berlin G
AD  - Department of Clinical Immunology and Transfusion Medicine, and Department of 
      Biomedical and Clinical Sciences, Linkoping University, Linkoping, Sweden.
FAU - Segelmark, M
AU  - Segelmark M
AD  - Department of Clinical Sciences, Lund University, Lund, Sweden.
FAU - Javier Martinez, A
AU  - Javier Martinez A
AD  - Uppsala University, Uppsala, Sweden.
FAU - Audzijoniene, J
AU  - Audzijoniene J
AD  - Vilnius University, Vilnius, Lithuania.
FAU - Griskevicius, A
AU  - Griskevicius A
AD  - Vilnius University, Vilnius, Lithuania.
FAU - Newman, E
AU  - Newman E
AD  - Concord Hospital, Sydney, Australia.
FAU - Blaha, M
AU  - Blaha M
AD  - Kralove University, Kralove, Czech Republic.
FAU - Vrielink, H
AU  - Vrielink H
AD  - Sanquin, Amsterdam, Netherlands.
FAU - Witt, V
AU  - Witt V
AD  - St Anna Kinderspital, Vienna, Austria.
FAU - Stegmayr, B
AU  - Stegmayr B
AD  - Umea University, Umea, Sweden. Electronic address: bernd.stegmayr@umu.se.
LA  - eng
PT  - Journal Article
DEP - 20210731
PL  - England
TA  - Transfus Apher Sci
JT  - Transfusion and apheresis science : official journal of the World Apheresis 
      Association : official journal of the European Society for Haemapheresis
JID - 101095653
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*therapy
MH  - Blood Component Removal/*methods
MH  - Child
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Registries
MH  - Young Adult
OTO - NOTNLM
OT  - Anti-GBM
OT  - Antibodies
OT  - MPO
OT  - PR-3
OT  - Renal impairment
OT  - Therapeutic apheresis
OT  - Vasculitis
EDAT- 2021/08/14 06:00
MHDA- 2022/02/24 06:00
CRDT- 2021/08/13 05:52
PHST- 2021/05/13 00:00 [received]
PHST- 2021/07/29 00:00 [revised]
PHST- 2021/07/29 00:00 [accepted]
PHST- 2021/08/14 06:00 [pubmed]
PHST- 2022/02/24 06:00 [medline]
PHST- 2021/08/13 05:52 [entrez]
AID - S1473-0502(21)00214-7 [pii]
AID - 10.1016/j.transci.2021.103227 [doi]
PST - ppublish
SO  - Transfus Apher Sci. 2021 Dec;60(6):103227. doi: 10.1016/j.transci.2021.103227. 
      Epub 2021 Jul 31.