Alveolar haemorrhage in ANCA-associated vasculitis: Long-term outcome and mortality predictors

Quartuccio, Luca; Bond, Milena; Isola, Miriam; Monti, Sara; Felicetti, Mara; Furini, Federica; Murgia, Stefano; Berti, Alvise; Silvestri, Elena; Pazzola, Giulia; Bozzolo, Enrica; Leccese, Pietro; Raffeiner, Bernd; Parisi, Simone; Leccese, I.; Cianci, Francesco; Bettio, Silvano; Sainaghi, Pierpaolo; Ianniello, Aurora; Ravagnani, Viviana; Randone, Silvia Bellando; Faggioli, Paola; Lomater, Claudia; Stobbione, Paolo; Ferro, Francesco; Colaci, Michele; Alfieri, Giuseppina; Carubbi, Francesco; Erre, Gian Luca; Giollo, Alessandro; Franzolini, Nicoletta; Ditto, Maria Chiara; Balduzzi, Silvia; Padoan, Roberto; Bortolotti, Roberto; Bortoluzzi, Alessandra; Cariddi, Adriana; Padula, Angela; Scala, Gerardo Di; Gremese, Elisa; Conti, Fabrizio; D’Angelo, Salvatore; Cerinic, Marco Matucci; Dagna, Lorenzo; Emmi, Giacomo; Salvarani, Carlo; Paolazzi, Giuseppe; Roccatello, Dario; Govoni, Marcello; Schiavon, Franco; Caporali, Roberto; Vita, Salvatore De

doi:10.1016/j.jaut.2019.102397

Cited by 35 publications

(22 citation statements)

References 43 publications

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“…Pulmonary involvement is one of the most frequently reported involvement as our finding [32]. We found the most common organ involvement as renal like previous reports revealed after pulmonary involvement [5,33].…”

Section: Discussionsupporting

confidence: 82%

Clinical Characteristics and Outcome of ANCA-Associated Vasculitis; Experience of A Single Reference Vasculitis Center

et al. 2020

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Objective: The aim of the study is to describe the clinical characteristics of Antineutrophil cytoplasmic antibodies-associated vasculitis and to analyze the parameters affecting the outcome. Materials and Methods: The study is a retrospective cohort study. Totally 130 patients with Antineutrophil cytoplasmic antibodies-associated vasculitis (18 years and over) who were followed up between October 2014 and October 2019 were analyzed. Demographic data, laboratory values, clinical course, thorax computed tomography findings and treatment approaches were noted from the charts of patients. Patients were divided into two groups as those with pulmonary involvement and non-pulmonary involvement. Results: We retrospectively reviewed the medical records of 130 patients with Antineutrophil cytoplasmic antibodies-associated vasculitis; 111 with granulomatosis with polyangiitis, 15 with microscopic polyangiitis, 1 with eosinophilic granulomatosis with polyangiitis, and 3 with other types of vasculitis. The ratio of having the abnormality in thoracic computed tomography was 72.2%. There were 84 cases with pulmonary involvement and 46 cases with non-pulmonary involvement. The frequency of microscopic polyangiitis was significantly higher (p=0.034) in non-pulmonary involvement cases. There were 67 cases with proteinase 3 Antineutrophil cytoplasmic antibodies and 39 cases with myeloperoxidase Antineutrophil cytoplasmic antibodies positivity. Most of the cases with proteinase 3 Antineutrophil cytoplasmic antibodies positivity were classified as granulomatosis with polyangiitis, this was statistically significant. Recovery was referenced for the outcome. Any of the variables were found statistically significant effective on outcome. Conclusions: Cases with pulmonary involvement were more than the cases without pulmonary involvement in our study. microscopic polyangiitis was significantly higher in non- pulmonary involvement cases. We studied on a large group, and these significant findings may have important implications for the investigation, pathogenesis, and treatment of Antineutrophil cytoplasmic antibodies-associated vasculitis.

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Section: Discussionsupporting

confidence: 82%

Clinical Characteristics and Outcome of ANCA-Associated Vasculitis; Experience of A Single Reference Vasculitis Center

et al. 2020

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“…In addition, interstitial lung disease and diffuse alveolar haemorrhage at diagnosis have been known as important risk factors for all-cause mortality during follow-up in patients with AAV. 15,16 The cumulative survival rates were significantly lower in patients with interstitial lung disease and those with diffuse alveolar haemorrhage at diagnosis compared to those without lung manifestations (p=0.034 and p=0.006, respectively) ( Supplementary Fig. 2, only online).…”

Section: Discussionmentioning

confidence: 94%

Rituximab Biosimilar Prevents Poor Outcomes of Microscopic Polyangiitis and Granulomatosis with Polyangiitis as Effectively as Rituximab Originator

et al. 2020

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Purpose: There has been no extensive study to compare the efficacy between rituximab originator (Mabthera ®) and its biosimilar (Truxima ®) for microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA). Here, we investigated the clinical effects of rituximab on poor outcomes of MPA and GPA in Korean patients, and compared those between Mabthera ® and Truxima ®. Materials and Methods: We retrospectively reviewed the medical records of a total of 139 patients, including 97 MPA patients and 42 GPA patients. At diagnosis, antineutrophil cytoplasmic antibody positivity and comorbidities were assessed. During follow-up, all-cause mortality, relapse, end-stage renal disease, cerebrovascular accident and acute coronary syndrome were evaluated as poor outcomes. In this study, rituximab was used as either Mabthera ® or Truxima ®. Results: The median age at diagnosis was 60.1 years and 46 patients were men (97 MPA and 42 GPA patients). Among poor outcomes, patients receiving rituximab exhibited a significantly lower cumulative relapse-free survival rate compared to those not receiving rituximab (p=0.002). Nevertheless, rituximab use did not make any difference in other poor outcomes of MPA and GPA except for relapse, which might be a rebuttal to the fact that rituximab use after relapse eventually led to better prognosis. There were no significant differences in variables at diagnosis and during follow-up between patients receiving Mabthera ® and those receiving Truxima ®. Patients receiving Truxima ® exhibited a similar pattern of the cumulative survival rates of each poor outcome to those receiving Mabthera ®. Conclusion: Truxima ® prevents poor outcomes of MPA and GPA as effectively as does Mabthera ® .

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“…The latter complication was present only in one AAV patient in previous years. 2 Seven out of nine (78%) patients were admitted to intensive care units for severe respiratory insufficiency (one patient in 2018 only). Seven out of nine (78 %) patients with glomerulonephritis required renal replacement therapy compared with no patient in the same period of 2019 and one in 2018; one patient required extracorporeal mechanical oxygenation for respiratory support.…”

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confidence: 99%

Challenge of diagnosing ANCA-associated vasculitis during COVID-19 pandemic: a missed ‘window of opportunity’

et al. 2020

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Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research. Patient consent for publication Not required. Provenance and peer review Not commissioned; internally peer reviewed. This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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Alveolar haemorrhage in ANCA-associated vasculitis: Long-term outcome and mortality predictors

Cited by 35 publications

References 43 publications

Clinical Characteristics and Outcome of ANCA-Associated Vasculitis; Experience of A Single Reference Vasculitis Center

Clinical Characteristics and Outcome of ANCA-Associated Vasculitis; Experience of A Single Reference Vasculitis Center

Rituximab Biosimilar Prevents Poor Outcomes of Microscopic Polyangiitis and Granulomatosis with Polyangiitis as Effectively as Rituximab Originator

Challenge of diagnosing ANCA-associated vasculitis during COVID-19 pandemic: a missed ‘window of opportunity’

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