ArticleArthritis care & research2017
Variation in the Treatment of Children Hospitalized With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis in the US.
Article in Arthritis care & research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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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.
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.
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Who cites it
9 citing papers in PubMed.
- Phase IIa Global Study Evaluating Rituximab for the Treatment of Pediatric Patients With Granulomatosis With Polyangiitis or Microscopic Polyangiitis.Arthritis & rheumatology (Hoboken, N.J.) · 2022Trial
- Two Decades Rituximab Therapy in Anti-Neutrophil Cytoplasmic Antibody Associated Vasculitis.Current drug targets · 2025Review
- The Association Between Age at Diagnosis and Disease Characteristics and Damage in Patients With ANCA-Associated Vasculitis.Arthritis & rheumatology (Hoboken, N.J.) · 2023Article
- Cardiac involvement and cardiovascular risk factors in pediatric primary systemic vasculitides.Clinical rheumatology · 2023Review
- Membranous nephropathy: diagnosis, treatment, and monitoring in the post-PLA2R era.Pediatric nephrology (Berlin, Germany) · 2021Review
- [Diffuse alveolar hemorrhage in children].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2019Review
- Childhood- Versus Adult-Onset Primary Vasculitides: Are They Part of the Same Clinical Spectrum?Current rheumatology reports · 2019Review
- Primary Vasculitis in Childhood: GPA and MPA in Childhood.Frontiers in pediatrics · 2018Review
- ANCA-associated vasculitis in childhood: recent advances.Italian journal of pediatrics · 2017Review
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
objectiveThere are few reports on the treatment of antineutrophil cytoplasmic antibody-associated vasculitis (AAV) in children. This study characterizes the use of cyclophosphamide, rituximab, and plasma exchange in children hospitalized with AAV in the US.
methodsWe conducted a retrospective cohort study of children hospitalized with AAV from 2004-2014 utilizing an administrative and billing database from 47 tertiary care pediatric hospitals. All patients had an International Classification of Diseases, Ninth Revision, Clinical Modification discharge code of 446.4 and ≥1 charge for glucocorticoids. Treatment receipt was determined using billing data. Mixed-effects logistic regression was used to evaluate factors associated with the likelihood of receipt of each of the 3 treatments.
resultsDuring the 11-year study period there were 1,290 admissions for 393 children. The median age at index admission was 14.6 years, and 61% were female. Dialysis or mechanical ventilation was required by 16% and 17% of the children, respectively. The median length of stay was 9 days. The percentages of children receiving cyclophosphamide, rituximab, or both were 57%, 21%, and 10%, respectively, and 22% received plasma exchange. Mechanical ventilation was associated with the receipt of cyclophosphamide and plasma exchange, but not rituximab. There was an increasing trend in the use of rituximab over time during the study period (P < 0.05), and a decreasing trend in the use of cyclophosphamide (P < 0.05). Treatment use varied significantly between hospitals, especially for plasma exchange.
conclusionThe treatment of children with severe AAV is shifting from cyclophosphamide to rituximab, and their need for dialysis, mechanical ventilation, and prolonged hospitalization remains common. Use of plasma exchange is highly variable.
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