Evidence map›Paper›PMID 26552432›Full record

ArticleBMC musculoskeletal disorders2015

Benefits of an expanded use of plasma exchange for anti-neutrophil cytoplasmic antibody-associated vasculitis within a dedicated clinical service.

Neeraj Dhaun, Andrew Saunders, Christopher O Bellamy, Rocío Martinez Gallardo, Lynn Manson, David C Kluth

Open access · goldAbstract read
In one paragraph

Article in BMC musculoskeletal disorders, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
0.5field-weighted citation impact, top 30% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Cyclophosphamide-Induced Lung Injury.Kidney international reports · 2019
    Article
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

6 authors at 1 institution in 1 country.

Neeraj DhaunBHF Centre of Research Excellence, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, EH16 4TJ, Edinburgh, UK. bean.dhaun@ed.ac.uk.
Andrew SaundersDepartment of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK. andrew.saunders18@btinternet.com.
Christopher O BellamyDepartment of Pathology, Royal Infirmary of Edinburgh, Edinburgh, UK. c.bellamy@ed.ac.uk.
Rocío Martinez GallardoDepartment of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK. rociomartinezgallardo@hotmail.com.
Lynn MansonScottish National Blood Transfusion Service, Edinburgh, UK. lynnmanson@nhs.net.
David C KluthDepartment of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK. david.kluth@ed.ac.uk.
Edinburgh Royal Infirmary · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent recommendations for ANCA-associated vasculitis (AAV) support its management within a dedicated clinical service. Therapies for AAV are imperfect with many patients failing to achieve disease control and others experiencing disease relapse. Plasma exchange (PEX) may be beneficial especially when the kidney is involved.

methodsWithin a new, dedicated service we retrospectively assessed, over a 6-year period, the benefits of PEX in two patient cohorts, discriminated by PEX treatment alone. Patients received PEX alongside standard of care if they fulfilled any of the following criteria: 1. serum creatinine >500 μmol/l or dialysis-requiring renal failure, 2. alveolar haemorrhage, 3. renal biopsy showing ≥30 % focal and necrotising lesions ± cellular crescents. Outcome measures included disease remission and relapse, cumulative immunosuppression, and morbidity and mortality.

resultsOf 104 new patients, 58 patients received PEX at presentation, 46 did not. Cyclophosphamide and/or rituximab dosing was similar for both groups. Although patients receiving PEX had poorer renal function, a higher C-reactive protein and disease activity score at presentation disease remission rate was similar in both groups (no PEX vs. PEX: 96 % vs. 98 %). The PEX group entered remission quicker (no PEX vs. PEX: 3.9 ± 4.0 vs. 2.8 ± 1.3 months, p < 0.05), with a lower 3-month cumulative glucocorticoid dose (no PEX vs. PEX: 2.5 ± 0.4 vs. 2.3 ± 0.2 g, p < 0.001). Relapse was similar between groups but adverse events lower in the PEX group.

conclusionsPEX may be of benefit in AAV. Larger, longer randomised controlled trials are now needed.

Indexed as

AdultAgedAged, 80 and overAnti-Neutrophil Cytoplasmic Antibody-Associated VasculitisFemaleHealth ServicesHumansImmunosuppression TherapyMaleMiddle AgedPlasma ExchangeRecurrenceRemission InductionRetrospective Studies

Identifiers

PMID26552432
PMCPMC4640165
OpenAlexW2132271630

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.