Risk factors for treatment resistance and relapse of Chinese patients with MPO-ANCA-associated vasculitis
| Autor: | Li Huang, Chanjuan Shen, Wei Lin, Yong Zhong, Xiangcheng Xiao, Joshua D. Ooi, Ya Ou Zhou, Ting Wu, Ping Xiao, Qiaoling Zhou, Ting Meng, Zhou Xiao, Xiang Ao, Jinbiao Chen |
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| Rok vydání: | 2020 |
| Předmět: |
Male
0301 basic medicine medicine.medical_specialty Globulin Prednisolone Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis Kidney Gastroenterology General Biochemistry Genetics and Molecular Biology 03 medical and health sciences 0302 clinical medicine Recurrence Risk Factors Internal medicine medicine Humans Cyclophosphamide Aged Peroxidase Retrospective Studies Hematology biology business.industry Hazard ratio Retrospective cohort study General Medicine Odds ratio Middle Aged medicine.disease Treatment Outcome 030104 developmental biology Creatinine 030220 oncology & carcinogenesis Myeloperoxidase Cohort biology.protein Female Vasculitis business |
| Zdroj: | Clinical and Experimental Medicine. 20:199-206 |
| ISSN: | 1591-9528 1591-8890 |
| DOI: | 10.1007/s10238-020-00614-7 |
| Popis: | Identification of risk factors for treatment resistance and relapse would be crucial to personalization therapy in patients with myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (MPO-AAV). Current evidence with regard to the risk factors for treatment resistance and relapse remains limited and inconclusive. We aimed to assess the predictors for treatment resistance and relapse in a single-center cohort of Chinese patients with MPO-AAV in this study. In total, 184 patients with MPO-AAV were included. Treatment resistance occurred in 64 (34.9%) of 184 patients and was positively associated with lung involvement (odds ratio [OR] 3.581, 95% CI 1.137-11.278, p = 0.029) and the initial serum creatinine level (OR 1.004, 95% CI 1.001-1.007, p = 0.010) and was negatively associated with platelet (OR 0.992, 95% CI 0.987-0.998, p = 0.007) and serum C3 levels (OR 0.998, 95% CI 0.996-0.999, p = 0.004). Relapse occurred in 29 (24.17%) of 120 patients in whom remission was achieved and was independently associated with lung involvement (hazard ratio [HR] 4.595, 95% CI 1.272-16.599, p = 0.020) and cardiovascular involvement (HR 3.689, 95% CI 1.237-11, p = 0.019,). The serum globulin was demonstrated to be negatively associated with relapse independently (HR 0.876; 95% CI 0.806-0.953; p = 0.002). This retrospective study of MPO-AAV patients in a single Chinese center suggests that treatment resistance was positively associated with lung involvement and the initial serum creatinine level and was negatively associated with platelet and serum C3 levels. Lung involvement and cardiovascular involvement were associated with an increased risk of relapse, while the higher serum globulin was demonstrated to be in association with a decreased risk of relapse. |
| Databáze: | OpenAIRE |
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