SynthesisClinical and experimental immunology2020
The alternative complement pathway in ANCA-associated vasculitis: further evidence and a meta-analysis.
Synthesis in Clinical and experimental immunology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
46 citing papers in PubMed, 1 synthesis or guideline pooled it, 63 citations in OpenAlex.
- Non-invasive biomarkers of disease activity and organ damage in ANCA-associated vasculitis: a systematic review.RMD open · 2024Pooled it
- Complement and kidney diseases: unlocking the opportunity of targeted treatments for glomerular diseases, including IgA nephropathy.Pediatric nephrology (Berlin, Germany) · 2026Review
- Anti-neutrophil cytoplasmic antibody-associated vasculitis: biological insights and biomarker-guided disease management.Nature reviews. Nephrology · 2026Review
- Article
- Mechanisms, clinical manifestations and management of cardiovascular diseases in ANCA-associated vasculitis.Rheumatology (Oxford, England) · 2026Review
- Advances in the Diagnosis, Treatment and Prognosis of ANCA-Associated Glomerulonephritis.Medicina (Kaunas, Lithuania) · 2026Review
- Real-world outcomes of avacopan beyond the first year in antineutrophil cytoplasmic antibody-associated vasculitis: a retrospective cohort study.BMC rheumatology · 2026Article
- Evolving Therapeutic Strategies in ANCA-Associated Vasculitis: Current Standards and Emerging Targets for GPA and MPA.Clinical reviews in allergy & immunology · 2026Review
- The Complement System in ANCA-Associated Vasculitis: Mechanistic Insights, Therapeutic Horizons, and Unmet Clinical Needs.Immunity, inflammation and disease · 2026Review
- Urinary complement C3 fragment levels and their clinical relevance in MPO-ANCA-associated vasculitis.Scientific reports · 2026Article
- Spatial transcriptomics reveals injury-responsive compartments and coordinated immune-fibrotic signaling in ANCA-associated renal vasculitis.Frontiers in immunology · 2026Article
- Making use of avacopan in clinical practice.Clinical kidney journal · 2026Review
- Novel Treatment Paradigms: Complement Inhibition in Antineutrophil Cytoplasmic Autoantibody Vasculitis.Kidney international reports · 2025Review
- Avacopan in the treatment of relapsing polychondritis with myeloperoxidase-antineutrophil cytoplasmic antibody associated vasculitis: A case report.World journal of nephrology · 2025Article
- Avacopan is effective in inducing remission for MPA/GPA, regardless of changes in serum C5a levels: a single-center study in Japan.BMC rheumatology · 2025Article
- Advances in the treatment of ANCA-associated vasculitis.Nature reviews. Rheumatology · 2025Review
- Arterial and venous thrombosis in systemic and monogenic vasculitis.Nature reviews. Rheumatology · 2025Review
- Association of C4d with disease activity in anti-neutrophil cytoplasmic antibody-associated vasculitis: evidence for classical/lectin complement pathway activation.Arthritis research & therapy · 2025Article
- Complement factors as biomarkers in ANCA-associated vasculitis in remission.Clinical and experimental immunology · 2025Article
- Circulating B cells display differential immune regulatory molecule expression in granulomatosis with polyangiitis.Clinical and experimental immunology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We compared the common pathway components C3a, C5a and membrane attack complex (MAC), also known as C5b-9, and the alternative pathway components factor B and properdin in patients with ANCA-associated vasculitis (AAV) and healthy controls, and conducted a meta-analysis of the available clinical evidence for the role of complement activation in the pathogenesis of AAV. Complement components were evaluated in 59 patients with newly diagnosed or relapsing granulomatosis with polyangiitis or microscopic polyangiitis and 36 healthy volunteers. In 28 patients, testing was repeated in remission. Next, we performed a meta-analysis by searching databases to identify studies comparing complement levels in AAV patients and controls. A random-effects model was used for statistical analyses. The median concentrations of MAC, C5a, C3a and factor B were higher in active AAV patients (P < 0·001). Achievement of remission was associated with reductions in C3a (P = 0·005), C5a (P = 0·035) and factor B levels (P = 0·045), whereas MAC and properdin levels did not change. In active AAV, there were no effects of ANCA specificity, disease phenotype, previous immunosuppression or disease severity on complement levels. A total of 1122 articles were screened, and five studies, including this report, were entered into the meta-analysis. Plasma MAC, C5a and factor B in patients with active AAV were increased compared to patients in remission (excluding factor B) and controls. Changes in C3a were of borderline significance. Our findings and the results of the meta-analysis support activation of the complement system predominantly via the alternative pathway in AAV patients.
Indexed as
Identifiers
What OpenQuestion holds
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.