ArticleClinical journal of the American Society of Nephrology : CJASN2023
Maintenance of Remission and Risk of Relapse in Myeloperoxidase-Positive ANCA-Associated Vasculitis with Kidney Involvement.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Guideline
- Anti-neutrophil cytoplasmic antibody-associated vasculitis: biological insights and biomarker-guided disease management.Nature reviews. Nephrology · 2026Review
- Towards a proteomic plasma biomarker panel for diagnosing vasculitis remission.Nature communications · 2026Article
- Evolving Therapeutic Strategies in ANCA-Associated Vasculitis: Current Standards and Emerging Targets for GPA and MPA.Clinical reviews in allergy & immunology · 2026Review
- Kidney Transplantation in Childhood-Onset ANCA-Associated Vasculitis: Long-Term Outcomes and Prognostic Factors.Clinical journal of the American Society of Nephrology : CJASN · 2026Article
- Repeat kidney biopsy reveals new-onset IgA nephropathy in a patient with ANCA-associated vasculitis.CEN case reports · 2026Article
- ANCA-associated vasculitis: a phase-oriented therapeutic framework from immunopathology to precision treatment.Frontiers in medicine · 2026Review
- Case report: Recurrence of anti-myeloperoxidase pauci-immune crescentic glomerulonephritis in a kidney transplant recipient; potential association with HLA antigens and seropositivity?Frontiers in immunology · 2026Article
- Article
- Prediction of relapses in patients with small vessel vasculitides: a multicenter cohort study on histopathological risk patterns.Rheumatology international · 2025Article
- Challenges in the diagnosis, classification and prognosis of ANCA-associated vasculitis.Nature reviews. Rheumatology · 2025Review
- Advances in the treatment of ANCA-associated vasculitis.Nature reviews. Rheumatology · 2025Review
- Review
- Top ten tips in managing ANCA vasculitis.Clinical kidney journal · 2025Review
- How We Treat ANCA-Associated Vasculitis: A Focus on the Maintenance Therapy.Journal of clinical medicine · 2025Review
- Clinical value at baseline and follow-up of myeloperoxidase-antibodies in ANCA-associated vasculitis.Frontiers in immunology · 2025Article
- Antineutrophil cytoplasmic antibody-associated vasculitis: insights into relapse risk and future management directions.Frontiers in immunology · 2025Review
- [Update on treatment of ANCA-associated vasculitis].Zeitschrift fur Rheumatologie · 2024Review
- An update on risk factors for relapse in antineutrophil cytoplasmic antibody-associated vasculitis.Clinical and experimental immunology · 2024Review
- Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in China: Epidemiology, Management, Prognosis, and Outlook.Kidney diseases (Basel, Switzerland) · 2024Review
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Authors and funding
13 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe optimal strategy for remission-maintenance therapy in patients with myeloperoxidase-ANCA (MPO-ANCA)-associated vasculitis is not established. Defining parameters to guide maintenance therapy is required.
methodsThis was a retrospective cohort study of all patients with MPO-ANCA-associated vasculitis (microscopic with polyangiitis and granulomatosis with polyangiitis) and GN followed at the Mayo Clinic between 1996 and 2015. Relapse rate, MPO-ANCA status, and remission-maintenance therapies were reviewed. Logistic regression models, Kaplan-Meier method, and Cox proportional hazards regression models were applied.
resultsWe analyzed 159 patients with active MPO-ANCA-associated vasculitis with GN. Sixty-six (42%) patients had at least one relapse, and 52 (33%) relapsed before 60 months. Patients with MPO-ANCA who became persistently negative did not relapse (hazard ratio [HR], 0.03; 95% confidence interval [95% CI], 0.002 to 0.431; P =0.01). The reappearance of MPO-ANCA was associated with a higher risk of relapse (HR, 1.91; 95% CI, 1.109 to 3.293; P =0.02). Immunosuppression was withdrawn in 80 (50%) patients, and this was less likely in those who received cyclophosphamide for remission induction or in patients with persistently positive MPO-ANCA (odds ratio [OR], 0.44; 95% CI, 0.228 to 0.861; P =0.02 and OR, 0.42; 95% CI, 0.213 to 0.820; P =0.01, respectively). Relapse frequency was not different between patients with persistently positive MPO-ANCA and patients with MPO-ANCA reappearance (44% versus 39%, P =0.49), irrespective of remission-maintenance treatment. Ear, nose, and throat involvement (OR, 6.10; 95% CI, 1.280 to 29.010; P =0.02) and MPO-ANCA reappearance (OR, 9.25; 95% CI, 3.126 to 27.361; P <0.001) were independently associated with relapse after treatment withdrawal.
conclusionsPatients persistently MPO-ANCA negative are at low risk for relapse even without remission-maintenance therapy. Persistence or subsequent reappearance of MPO-ANCA is associated with a higher risk of relapse. PODCAST: This article contains a podcast at https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast.aspx?p=CJASN&e=2023_01_10_CJN06460622.mp3.
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