Serum calprotectin and renal function decline in ANCA-associated vasculitides: a post hoc analysis of MAINRITSAN trial.

Autor:	Romand X; CNRS, UMR 5525, T-RAIG, TIMC, CHU Grenoble Alpes, Universite Grenoble Alpes, Grenoble, France xromand@chu-grenoble.fr., Paclet MH; CNRS, UMR 5525, T-RAIG, TIMC, CHU Grenoble Alpes, Universite Grenoble Alpes, Grenoble, France., Chuong MV; CNRS, UMR 5525, T-RAIG, TIMC, CHU Grenoble Alpes, Universite Grenoble Alpes, Grenoble, France., Gaudin P; CNRS, UMR 5525, T-RAIG, TIMC, CHU Grenoble Alpes, Universite Grenoble Alpes, Grenoble, France., Pagnoux C; Vasculitis clinic, Mount Sinai Hospital, Toronto, Ontario, Canada., Guillevin L; Université de Paris, Paris, France.; Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hopital Cochin APHP-Centre Université Paris (CUP), Paris, France., Terrier B; Université de Paris, Paris, France.; Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hopital Cochin APHP-Centre Université Paris (CUP), Paris, France., Baillet A; CNRS, UMR 5525, T-RAIG, TIMC, CHU Grenoble Alpes, Universite Grenoble Alpes, Grenoble, France.
Jazyk:	angličtina
Zdroj:	RMD open [RMD Open] 2023 Oct; Vol. 9 (4).
DOI:	10.1136/rmdopen-2023-003477
Abstrakt:	Objective: Serum calprotectin appears to be an interesting biomarker associated with renal vascular disease activity in antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV). The aim of this study was to assess whether serum calprotectin levels can predict decline in renal function in AAV patients receiving maintenance therapy. Methods: Serum calprotectin levels were assessed at inclusion and month 6 in AAV patients, in complete remission after induction therapy, randomly assigned to rituximab or azathioprine. Renal function decline was defined as a 25% decrease in estimated glomerular filtration rate (eGFR) and a change in the eGFR category, or a decrease of 15 mL/min/1.73 m 2 . Relapse was defined as a Birmingham Vasculitis Activity Score >0 attributable to active vasculitis. Results: Seventy-six AAV were included. Serum calprotectin increased from baseline to month 6 in patients with renal function decline (7940 (-226.0, 28 691) ng/ml vs -4800 (-18 777, 3708) ng/ml; p<0.001). An increase of calprotectin level was associated with a higher risk of subsequent renal function decline even after adjustment (OR 6.50 (95% CI 1.7 to 24.9) p=0.006). A significantly higher risk of relapse was observed in proteinase 3- AAV patients with an increase of serum calprotectin levels (OR 5.6 (95% CI 1.0 to 31.2), p=0.03). Conclusion: An increase in serum calprotectin by month 6 compared with inclusion during remission-maintenance therapy in AAV was associated with a higher risk of renal function decline in the following 12 months. Trial Registration Number: NCT00748644. Competing Interests: Competing interests: Roche has provided rituximab for the MAINRITSAN trial. MAINRITSAN trial was supported by the French Ministry of Health. XR reported personal fees from Abbvie, MSD, UCB, Novartis, Celltrion Healthcare, Galapagos and CHUGAI pharma for presentations, speakers or educational events.MHP did not report any other conflicts of interest. MVC did not report any other conflicts of interest. PG did not report any other conflicts of interest. CP reported receiving grant from Pfizer, TEVA, Roche and personal fees from GSK, Roche, Amgen, Pfizer for lectures, presentations, speakers, manuscript writing or educational events and from Sanofi, ChemoCentryx, AstraZeneca, InflaRx and Otsuka for participation on a data safety monitoring board or advisory board. LG did not report any other conflicts of interest. BT reported receiving consulting fees from Roche, Chugai, GSK and AstraZeneca. AB did not report any other conflicts of interest. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu