Evidence map›Paper›PMID 35570996›Full record

ArticleKidney international reports2022

A Meta-Analysis of the Safety and Efficacy of Maintenance Therapies for Antineutrophil Cytoplasmic Antibody Small-Vessel Vasculitis.

Ioannis Bellos, Ioannis Boletis, Sophia Lionaki

Open access · goldAbstract read
In one paragraph

Article in Kidney international reports, 2022. 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
1.5field-weighted citation impact, top 17% 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, 10 citations in OpenAlex.

  1. [Diagnosis and treatment of ANCA-associated vasculitis : SHORT VERSION of the S3 guideline of the German Society for Rheumatology and Clinical Immunology e. V. (DGRh) and German Society for Internal Medicine e. V. (DGIM), German Society for Nephrology e. V. (DGfN), German Society for Otorhinolaryngology and Head and Neck Surgery e. V. (DGHNO-KHC), German Ophthalmological Society e. V. (DOG), German Society for Neurology e. V. (DGN), German Society for Pneumology and Respiratory Medicine e. V. (DGP), German Society for Pathology e. V. (DGP), German Radiological Society, Society for Medical Radiology e. V. (DRG), Federal Association of German Pathologists, Federal Kidney Association e. V., German Rheumatism League Federal Association e. V.]Zeitschrift fur Rheumatologie · 2025
    Guideline
  2. Pooled it
  3. Review
  4. 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

3 authors at 2 institutions in 1 country.

Ioannis BellosNational and Kapodistrian University of Athens, Faculty of Medicine, Athens, Greece.
Ioannis BoletisNational and Kapodistrian University of Athens, Faculty of Medicine, Athens, Greece.
Sophia LionakiNational and Kapodistrian University of Athens, Faculty of Medicine, Athens, Greece.
National and Kapodistrian University of Athens · GRLaiko General Hospital of Athens · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: To compare the efficacy and safety of different regimens used for maintenance of remission in patients with antineutrophil cytoplasmic antibody Methods: This network meta-analysis studied adult patients with ANCA vasculitis in complete remission, who were maintained with various regimens, excluding patients with eosinophilic granulomatosis with polyangiitis (GPA) and those who have ended up in end-stage kidney disease. Outcomes of interest included relapse (any/major), relapse-free survival, and adverse effects. PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and Google Scholar were systematically searched from inception. Results: Overall, the meta-analysis was based on 10 reports, describing the outcomes of 7 randomized controlled trials (RCTs) including 752 patients with ANCA vasculitis. Relapse-free survival was significantly worse with the use of azathioprine (hazard ratio [HR]: 2.11, 95% CI: 1.19-3.74), methotrexate (HR: 2.51, 95% CI: 1.24-5.08), and mycophenolate mofetil (HR: 3.57, 95% CI: 1.70-7.46) compared with the use of rituximab. Outcomes estimated for azathioprine (HR: 0.59, 95% CI: 0.37-0.94), cyclophosphamide (HR: 0.39, 95% CI: 0.20-0.75), and leflunomide (HR: 0.30, 95% CI: 0.11-0.84) were better than those for mycophenolate mofetil. When examining relapse-free survival, relapses were more likely with use of azathioprine (odds ratio [OR]: 2.15, 95% CI: 1.00-4.59) and mycophenolate mofetil (OR: 4.42, 95% CI: 1.63-11.94) compared with the use of rituximab. The risk of major relapse calculated for azathioprine (OR: 2.39, 95% CI: 1.10-5.19), methotrexate (OR: 3.18, 95% CI: 1.14-8.89), and mycophenolate mofetil (OR: 5.20, 95% CI: 1.65-16.37) was higher than that for rituximab. The rates of serious adverse effects did not differ significantly among interventions. Conclusion: Rituximab appears predominant in maintaining remission in patients with ANCA vasculitis with no cost in adverse events.

Indexed as

ANCAimmunosuppressionmaintenancerelapseremissionvasculitis

Identifiers

PMID35570996
PMCPMC9091778
OpenAlexW4214818261

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.