Evidence map›Paper›PMID 22975753›Full record

Trial reportAnnals of the rheumatic diseases2013

Serum proteins reflecting inflammation, injury and repair as biomarkers of disease activity in ANCA-associated vasculitis.

Paul A Monach, Roscoe L Warner, Gunnar Tomasson, Ulrich Specks, John H Stone, Linna Ding, Fernando C Fervenza, Barri J Fessler, Gary S Hoffman, David Iklé and 11 more

Registry-linked trialOpen access · greenAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Annals of the rheumatic diseases, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00104299 (Rituximab Therapy for the Induction of Remission and Tolerance in ANCA-Associated Vasculitis), which is not on this map. Cited by 63 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
63citing papers in PubMed, 4 pooled it
7.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00104299 phase2 / phase3completednot on this map

Rituximab Therapy for the Induction of Remission and Tolerance in ANCA-Associated Vasculitis (ITN021AI)

TypeinterventionalSponsorNational Institute of Allergy and Infectious Diseases (NIAID)Ran2005 to 2010Enrolled197ConditionsVasculitis, Wegener's Granulomatosis, Microscopic PolyangiitisArmsRituximab plus cyclophosphamide placebo (rituximab group), Cyclophosphamide plus rituximab placebo (control group), Azathioprine, Methylprednisolone (or other glucocorticoid), Prednisone
3 · Its place in the literature

Who cites it

63 citing papers in PubMed, 4 syntheses or guidelines pooled it, 139 citations in OpenAlex.

  1. Pooled it
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  3. Interventions for renal vasculitis in adults.The Cochrane database of systematic reviews · 2020
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3 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 15 institutions in 2 countries.

Paul A MonachVasculitis Center, Section of Rheumatology, and the Clinical Epidemiology Unit, Boston University School of Medicine, Boston, MA, USA.
Roscoe L Warner
Gunnar Tomasson
Ulrich Specks
John H Stone
Linna Ding
Fernando C Fervenza
Barri J Fessler
Gary S Hoffman
David Iklé
Cees G M Kallenberg
Jeffrey Krischer
Carol A Langford
Mark Mueller
Philip Seo
E William St Clair
Robert Spiera
Nadia Tchao
Steven R Ytterberg
Kent J Johnson
Peter A Merkel
Mayo Clinic · USBoston University · USCleveland Clinic · USImmune Tolerance Network · USUniversity of Michigan–Ann Arbor · USDuke University · USFlorida College · USHospital for Special Surgery · USJohns Hopkins University · USMassachusetts General Hospital · USNational Institute of Allergy and Infectious Diseases · USRho (United States) · USUniversity Medical Center Groningen · NLUniversity of Alabama at Birmingham · USUniversity of Pennsylvania · US

Funding

Institute for Clinical and Translational Research (UL1)UL1RR025005 · NCRR · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2007 to 2011
$75.8M
MAYO CLINIC CENTER FOR TRANSLATIONAL SCIENCE ACTIVITIESUL1RR024150 · NCRR · MAYO CLINIC ROCHESTER · PI RIZZA, ROBERT A. · 2006 to 2011
$66.4M
Clinical and Translational Science Collaborative of ClevelandUL1TR000439 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI KONSTAN, MICHAEL W. · 2012 to 2016
$50.0M
ZD6416 Analgesic--Painful Distal Symmetrical PolyneuropaM01RR001066 · NCRR · MASSACHUSETTS GENERAL HOSPITAL · PI BROWN, EMERY N · 1985 to 2008
$37.4M
YOGA INDUCED CHANGES IN BRAIN GABA LEVELSM01RR000533 · NCRR · BOSTON UNIVERSITY MEDICAL CAMPUS · PI HOLICK, MICHAEL F. · 1985 to 2008
$19.4M
WORK DISABILITY-- PERSONS WITH RHEUMATOID ARTHRITISP60AR047785 · NIAMS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI FELSON, DAVID TOBIN · 2001 to 2016
$18.0M
CTSA INFRASTRUCTURE FOR PEDIATRIC RESEARCHUL1RR025771 · NCRR · BOSTON UNIVERSITY MEDICAL CAMPUS · PI CENTER, DAVID M. · 2008 to 2011
$17.6M
Data Management and Coordinating Center (DMCC)U54NS064808 · NINDS · UNIVERSITY OF SOUTH FLORIDA · PI KRISCHER, JEFFREY P · 2009 to 2013
$16.5M
VCRC-VF FellowshipU54AR057319 · NIAMS · UNIVERSITY OF PENNSYLVANIA · PI MERKEL, PETER A · 2009 to 2020
$12.5M
VASCULITIS CLINICAL RESEARCH NETWORK (VCRN): RARE DISEASEU54RR019497 · NCRR · BOSTON UNIVERSITY MEDICAL CAMPUS · PI MERKEL, PETER A · 2003 to 2008
$6.1M
IDENTIFICATION AND VALIDATION OF BIOMARKERS FOR VASCULITISRC1AR058303 · NIAMS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI MERKEL, PETER A, MONACH, PAUL A · 2009 to 2010
$1.0M
Development of an ANCA-Vasculitis Index of Damage (AVID)K23AR052820 · NIAMS · JOHNS HOPKINS UNIVERSITY · PI SEO, PHILIP · 2005 to 2009
$661k
NCATS NIH HHS UL1 TR000439NCRR NIH HHS M01 RR000533NCRR NIH HHS M01 RR001066NCRR NIH HHS M01 RR00533NCRR NIH HHS RR024150-01NCRR NIH HHS RR025005NCRR NIH HHS RR 025771NCRR NIH HHS U54 RR019497NCRR NIH HHS UL1 RR024150NCRR NIH HHS UL1 RR025005NCRR NIH HHS UL1 RR025771NIAID NIH HHS N01 AI015416NIAMS NIH HHS K23 AR052820NIAMS NIH HHS K24 AR002224NIAMS NIH HHS K24 AR02224NIAMS NIH HHS K24 AR049185NIAMS NIH HHS P60 AR047785NIAMS NIH HHS P60AR047785NIAMS NIH HHS RC1 AR058303NIAMS NIH HHS U54 AR057319NIAMS NIH HHS U54AR057319NINDS NIH HHS NS064808NINDS NIH HHS U54 NS064808
6 · The paper itself

Abstract

objectiveTo identify circulating proteins that distinguish between active anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and remission in a manner complementary to markers of systemic inflammation.

methodsTwenty-eight serum proteins representing diverse aspects of the biology of AAV were measured before and 6 months after treatment in a large clinical trial of AAV. Subjects (n=186) enrolled in the Rituximab in ANCA-Associated Vasculitis (RAVE) trial were studied. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were available for comparison. The primary outcome was the ability of markers to distinguish severe AAV (Birmingham Vasculitis Activity Score for Wegener's granulomatosis (BVAS/WG)≥3 at screening) from remission (BVAS/WG=0 at month 6), using areas under receiver operating characteristic (ROC) curve (AUC).

resultsAll subjects had severe active vasculitis (median BVAS/WG=8) at screening. In the 137 subjects in remission at month 6, 24 of the 28 markers showed significant declines. ROC analysis indicated that levels of CXCL13 (BCA-1), matrix metalloproteinase-3 (MMP-3) and tissue inhibitor of metalloproteinases-1 (TIMP-1) best discriminated active AAV from remission (AUC>0.8) and from healthy controls (AUC>0.9). Correlations among these markers and with ESR or CRP were low.

conclusionsMany markers are elevated in severe active AAV and decline with treatment, but CXCL13, MMP-3 and TIMP-1 distinguish active AAV from remission better than the other markers studied, including ESR and CRP. These proteins are particularly promising candidates for future studies to address unmet needs in the assessment of patients with AAV.

Indexed as

AdultAgedAntibodies, Monoclonal, Murine-DerivedAnti-Neutrophil Cytoplasmic Antibody-Associated VasculitisBiomarkersBlood SedimentationChemokine CXCL13ChemokinesC-Reactive ProteinCytokinesDouble-Blind MethodFemaleHealth StatusHumansImmunologic FactorsMaleAntibodies, Monoclonal, Murine-DerivedBiomarkersChemokine CXCL13ChemokinesC-Reactive ProteinCXCL13 protein, humanCytokinesImmunologic FactorsMatrix Metalloproteinase 3ProteinsRituximabTIMP1 protein, humanTissue Inhibitor of Metalloproteinase-1Autoimmune DiseasesChemokinesCytokines

Identifiers

PMID22975753
PMCPMC4982463
OpenAlexW2103175993

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.