PMID- 34449460
OWN - NLM
STAT- MEDLINE
DCOM- 20210908
LR  - 20230103
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 100
IP  - 34
DP  - 2021 Aug 27
TI  - Efficacy of tacrolimus as maintenance therapy after cyclophosphamide for treating 
      antineutrophil cytoplasmic antibody-associated vasculitis.
PG  - e26956
LID - 10.1097/MD.0000000000026956 [doi]
LID - e26956
AB  - Azathioprine (AZA), methotrexate, or rituximab is used for the maintenance 
      therapy of antineutrophil cytoplasmic antibody-associated vasculitis (AAV). 
      Although the efficacy of tacrolimus (TAC) in various autoimmune diseases has been 
      demonstrated, there have been few reports on the efficacy of TAC in AAV. We 
      investigated the efficacy of TAC as maintenance therapy for AAV and compared its 
      efficacy with that of AZA.We retrospectively analyzed the medical records of 81 
      patients with AAV who received cyclophosphamide as induction therapy and AZA or 
      TAC as maintenance therapy. All-cause death, relapse, and progression to 
      end-stage renal disease (ESRD) were analyzed.Among 81 patients with AAV, 69 
      patients received AZA alone, 6 patients received TAC alone, and 6 patients 
      received TAC after AZA for maintenance therapy. Overall, 11 patients (13.6%) 
      died, 30 patients (37.0%) experienced relapse, and 16 patients (19.8%) progressed 
      to ESRD during a median of 33.8 months. No significant differences were observed 
      in cumulative patients', relapse-free, and ESRD-free survival rates between 
      patients administered AZA alone and TAC alone. There were no significant 
      differences in the cumulative patients' and relapse-free survival rate between 
      patients who received AZA alone and TAC after AZA. However, the cumulative 
      ESRD-free survival rate was lower in patients who received TAC after AZA than in 
      those who received AZA alone (P = .027).Patients who received TAC as maintenance 
      therapy showed a higher incidence of ESRD than those who received AZA; however, 
      this might be attributed to the lack of efficacy of AZA rather than the low ESRD 
      prevention effect of TAC.
CI  - Copyright (c) 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Pyo, Jung Yoon
AU  - Pyo JY
AD  - Division of Rheumatology, Department of Internal Medicine.
FAU - Lee, Lucy Eunju
AU  - Lee LE
AD  - Division of Rheumatology, Department of Internal Medicine.
FAU - Ahn, Sung Soo
AU  - Ahn SS
AD  - Division of Rheumatology, Department of Internal Medicine.
FAU - Song, Jason Jungsik
AU  - Song JJ
AD  - Division of Rheumatology, Department of Internal Medicine.
AD  - Institute for Immunology and Immunological Diseases, Yonsei University College of 
      Medicine, Seoul, Republic of Korea.
FAU - Park, Yong-Beom
AU  - Park YB
AD  - Division of Rheumatology, Department of Internal Medicine.
AD  - Institute for Immunology and Immunological Diseases, Yonsei University College of 
      Medicine, Seoul, Republic of Korea.
FAU - Lee, Sang-Won
AU  - Lee SW
AUID- ORCID: 0000-0002-8038-3341
AD  - Division of Rheumatology, Department of Internal Medicine.
AD  - Institute for Immunology and Immunological Diseases, Yonsei University College of 
      Medicine, Seoul, Republic of Korea.
LA  - eng
GR  - 6-2019-0184/Yonsei University College of Medicine/
GR  - HI14C1324/Korea Health Industry Development Institute/Republic of Korea
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Immunosuppressive Agents)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - MRK240IY2L (Azathioprine)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*drug 
      therapy/pathology
MH  - Azathioprine/adverse effects/*therapeutic use
MH  - Cyclophosphamide/therapeutic use
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Immunosuppressive Agents/adverse effects/*therapeutic use
MH  - Incidence
MH  - Kidney Failure, Chronic/pathology
MH  - Male
MH  - Middle Aged
MH  - Recurrence
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Tacrolimus/adverse effects/*therapeutic use
PMC - PMC8389966
COIS- The authors report no conflicts of interest.
EDAT- 2021/08/28 06:00
MHDA- 2021/09/09 06:00
PMCR- 2021/08/27
CRDT- 2021/08/27 17:22
PHST- 2021/03/03 00:00 [received]
PHST- 2021/07/29 00:00 [accepted]
PHST- 2021/08/27 17:22 [entrez]
PHST- 2021/08/28 06:00 [pubmed]
PHST- 2021/09/09 06:00 [medline]
PHST- 2021/08/27 00:00 [pmc-release]
AID - 00005792-202108270-00008 [pii]
AID - MD-D-21-01740 [pii]
AID - 10.1097/MD.0000000000026956 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2021 Aug 27;100(34):e26956. doi: 
      10.1097/MD.0000000000026956.