PMID- 38536523
OWN - NLM
STAT- Publisher
LR  - 20240327
IS  - 1435-4373 (Electronic)
IS  - 0934-9723 (Linking)
DP  - 2024 Mar 27
TI  - Suitability of reduced dose glucocorticoids therapy regimen for 
      antibody-associated vasculitis patients with TB: a retrospective study.
LID - 10.1007/s10096-024-04807-w [doi]
AB  - INTENTION: Immunosuppressive therapy is the major treatment approach for patients 
      with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV). Due to 
      impaired cellular immunological function and the use of glucocorticoids and 
      immunosuppressants, AAV patients are predisposed to opportunistic infections, 
      including tuberculosis (TB). This retrospective study aims to analyze the 
      clinical characteristics of patients with AAV and TB and explore suitable 
      glucocorticoid regimens for them. So as to provide a basis for future clinical 
      guidelines and have important value for guiding clinical treatment. METHODS: This 
      study retrospectively reviewed 58 AAV patients (18-80 years old) with TB admitted 
      to Changsha Central Hospital Affiliated with the University of South China from 
      2016.1 to 2023.4 Patients were divided into standard-dose and reduced-dose 
      glucocorticoid groups before retrospectively analyzing their medical records. 
      RESULTS: A total of 58 AAV patients with TB were enrolled, with 15 dying 
      throughout the monitoring period. Through analysis data, compared with the 
      standard-dose group, the reduced group had less proteinuria and hematuria. In 
      survival analysis, the reduced-dose glucocorticoid group had lower mortality than 
      the standard-dose group (P = 0.03); however, no significant difference was noted 
      in the use of immunoglobulin (P = 0.39), tuberculosis activity (P = 0.64), and 
      age stratification (P = 0.40). The BVAS score before treatment and 6 months 
      post-treatment suggest that the two regimens cause the same risk of ESKD 
      (P > 0.05). CONCLUSION: In conclusion, the reduced glucocorticoid dose group can 
      achieve the same curative effect as the standard dose group and has less damage 
      to the kidney in hematuria and proteinuria. Therefore, the reduced glucocorticoid 
      dose treatment regimen may be more suitable for AAV patients with TB.
CI  - (c) 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Wen, Rui
AU  - Wen R
AD  - The Affiliated Changsha Central Hospital, Department of Nephrology, Hengyang 
      Medical School, University of South China, Changsha, Hunan, 410004, China.
FAU - Xiao, Jingni
AU  - Xiao J
AD  - The Affiliated Changsha Central Hospital, Department of Nephrology, Hengyang 
      Medical School, University of South China, Changsha, Hunan, 410004, China.
FAU - Ding, Ning
AU  - Ding N
AD  - The Affiliated Changsha Central Hospital, Department of Emergency, Hengyang 
      Medical School, University of South China, Changsha, Hunan, 410004, China.
FAU - Zhong, Yong
AU  - Zhong Y
AD  - Department of Nephrology, Xiangya Hospital, Central South University, Changsha, 
      Hunan Province, China.
AD  - Key Laboratory of Biological Nanotechnology of National Health Commission, 
      Xiangya Hospital, Central South University, Changsha, Hunan, China.
FAU - Yuan, Qiong
AU  - Yuan Q
AD  - The Affiliated Changsha Central Hospital, Department of Nephrology, Hengyang 
      Medical School, University of South China, Changsha, Hunan, 410004, China.
FAU - Li, Jiali
AU  - Li J
AD  - The Affiliated Changsha Central Hospital, Department of Nephrology, Hengyang 
      Medical School, University of South China, Changsha, Hunan, 410004, China.
FAU - Wang, Qi
AU  - Wang Q
AD  - The Affiliated Changsha Central Hospital, Department of Nephrology, Hengyang 
      Medical School, University of South China, Changsha, Hunan, 410004, China.
FAU - Xie, Hebin
AU  - Xie H
AD  - The Affiliated Changsha Central Hospital, Department of drug clinical trial 
      institutions, Hengyang Medical School, University of South China, Changsha, 
      Hunan, 410004, China.
FAU - Qin, Jiao
AU  - Qin J
AD  - The Affiliated Changsha Central Hospital, Department of Nephrology, Hengyang 
      Medical School, University of South China, Changsha, Hunan, 410004, China. 
      QinJ8429@163.com.
AD  - Department of Nephrology, Changsha Central Hospital, University of South China, 
      South Shaoshan Road No. 161, Changsha, China. QinJ8429@163.com.
LA  - eng
GR  - Grant No. 2020JJ5611/Natural Science Foundation of Hunan Province/
GR  - No. 2020JJ8044/Natural Science Foundation of Hunan Province/
GR  - Grant No. 202203052625/Health Commission of Hunan Province/
GR  - Grant No.22A0321/Scientific Research Foundation of Education Department of Anhui 
      Province of China/
GR  - Great No. kzd21074 and 2021SK53410/Department of Science and Technology of Hunan 
      Province/
PT  - Journal Article
DEP - 20240327
PL  - Germany
TA  - Eur J Clin Microbiol Infect Dis
JT  - European journal of clinical microbiology & infectious diseases : official 
      publication of the European Society of Clinical Microbiology
JID - 8804297
SB  - IM
OTO - NOTNLM
OT  - ANCA-associated vasculitis
OT  - Eosinophilic granulomatous vasculitis
OT  - Glucocorticoids
OT  - Myeloperoxidase
OT  - Proteinase 3 granulomatous vasculitis
OT  - Tuberculosis
EDAT- 2024/03/27 18:45
MHDA- 2024/03/27 18:45
CRDT- 2024/03/27 12:19
PHST- 2023/09/15 00:00 [received]
PHST- 2024/03/11 00:00 [accepted]
PHST- 2024/03/27 18:45 [medline]
PHST- 2024/03/27 18:45 [pubmed]
PHST- 2024/03/27 12:19 [entrez]
AID - 10.1007/s10096-024-04807-w [pii]
AID - 10.1007/s10096-024-04807-w [doi]
PST - aheadofprint
SO  - Eur J Clin Microbiol Infect Dis. 2024 Mar 27. doi: 10.1007/s10096-024-04807-w.