Relevance of ANCA positivity at the time of renal transplantation in ANCA associated vasculitis

Geetha, Duvuru; Lee, Scott M.; Shah, Sneha; Rahman, Hafizur

doi:10.1007/s40620-015-0253-6

Cited by 16 publications

(8 citation statements)

References 34 publications

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“…1 , only online), similar to previous studies. 13 14 Therefore, we concluded that ANCA positivity at diagnosis might be closely associated with relapse, which more often required rituximab use compared to ANCA negativity.…”

Section: Discussionmentioning

confidence: 91%

“…1, only online), similar to previous studies. 13,14 Therefore, we concluded that ANCA positivity at diagnosis might be closely associated with relapse, which more often required rituximab use compared to ANCA negativity. 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.…”

Section: Discussionmentioning

confidence: 93%

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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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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 93%

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

et al. 2020

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“…86 Presence of positive ANCA titers should not preclude transplantation. However, presence of PR3-ANCA does carry a higher risk of relapse post-transplant, 87 and these patients require closer follow-up.…”

Section: Renal Transplant and Anca Vasculitismentioning

confidence: 99%

Treatment Updates in Antineutrophil Cytoplasmic Autoantibodies (ANCA) Vasculitis

et al. 2021

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Anti-neutrophil cytoplasmic autoantibody (ANCA) vasculitis is a small vessel vasculitis (SVV) resulting in inflammation of small- and medium-sized blood vessels. Since the initial description of SVV, there have been tremendous advances in our understanding of the pathogenesis. Over the last decade, we have made significant progress in understanding the pathogenesis and improving the treatment and prognosis of patients with ANCA vasculitis. Patient and renal survival has improved, and treatment is moving towards individualizing care, minimizing severe adverse events, and preventing relapse. This review focuses on treatment updates in ANCA vasculitis, duration of therapy, and management of relapses. We also describe the existing treatment protocols utilized at our institution.

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“…For this reason, despite the recurring nature of this disease, renal transplantation should be offered once they are eligible for patients with ESKD secondary to AAV. At the same time, the literature detailing the recurrence of AAV among kidney allograft recipients is equally extensive and compelling [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33].…”

Section: Introductionmentioning

confidence: 99%

Evaluating a Living Donor With Rheumatoid Arthritis for a Recipient With End-Stage Renal Disease From Antineutrophil Cytoplasmic Antibodies Associated Vasculitis

Souza

Ghahramani

Abendroth

et al. 2021

Cureus

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A 60-year-old Caucasian female with sero-positive rheumatoid arthritis (RA) was evaluated as a potential kidney donor for her brother-in-law with end-stage kidney disease (ESKD) secondary to c-antineutrophil cytoplasmic antibody (c-ANCA) associated vasculitis (AAV) and membranous nephropathy (MN). With little to no data supporting or contradicting this unique scenario, in addition to the varying viewpoints expressed by the different specialists, our multidisciplinary transplant committee encountered a difficult decision of whether to approve a candidate with RA for a living kidney donation or not. As a result, we carried out a careful literature review addressing aspects of recipients' outcomes following kidney transplants from a living donor with RA, especially when the recipient has AAV, living donor's short-and long-term outcomes post kidney donation, renal disease in AAV and RA, and maintenance of disease remission.

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Relevance of ANCA positivity at the time of renal transplantation in ANCA associated vasculitis

Abstract: This study demonstrates that PR3 ANCA+ patients may be more likely to experience relapse post-transplant. Further investigation of the predictors of vasculitis relapse among AAV patients who are ANCA+ at the time of RTx needs to be pursued.

Cited by 16 publications

References 34 publications

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

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

Treatment Updates in Antineutrophil Cytoplasmic Autoantibodies (ANCA) Vasculitis

Evaluating a Living Donor With Rheumatoid Arthritis for a Recipient With End-Stage Renal Disease From Antineutrophil Cytoplasmic Antibodies Associated Vasculitis

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