Granulomatosis With Polyangiitis (Wegener’s)
| Autor: | Springer, Jason, Nutter, Benjamin, Langford, Carol A., Hoffman, Gary S., Villa-Forte, Alexandra |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male AZA = azathioprine Time Factors Adolescent GPA = granulomatosis with polyangiitis MPO = myeloperoxidase Drug Administration Schedule CI = confidence interval Young Adult Recurrence IV = intravenous Azathioprine Humans Original Study MPA = microscopic polyangiitis PR3 = proteinase 3 Child Glucocorticoids Aged Retrospective Studies BVAS/WG = Birmingham Vasculitis Activity Score for Wegener Granulomatosis Aged 80 and over MTX = methotrexate ANCA = antineutrophil cytoplasmic antibody Remission Induction Granulomatosis with Polyangiitis RTX = rituximab Middle Aged Methotrexate MMF = mycophenolate mofetil CYC = cyclophosphamide HR = hazard ratio Female Immunosuppressive Agents |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 0025-7974 |
| Popis: | To determine outcomes in relation to duration of maintenance therapy in patients with granulomatosis with polyangiitis (Wegener’s) (GPA), we conducted a retrospective chart review of patients with GPA seen at a single vasculitis center from 1992 to 2010. All patients achieved remission defined by a Birmingham Vasculitis Activity Score for Wegener Granulomatosis (BVAS/WG) of 0 with either cyclophosphamide or methotrexate. After achieving remission all patients were started on maintenance therapy with either methotrexate or azathioprine. The study comprised 157 patients with a median follow-up of 3.1 years. Using a univariate model, the continuation of maintenance medications for >18 months showed a 29% reduction in hazard ratio (HR) for relapse (HR, 0.71; 95% confidence interval [CI], 0.42–1.19; p = 0.19). Treatment for >36 months showed a 66% reduction in hazard ratio for relapse (HR, 0.34; 95% CI, 0.15–0.76; p = 0.008). When length of treatment was considered as a continuous factor, longer courses had an inverse relationship with the risk of relapse (HR, 0.70; 95% CI, 0.58–0.84; p < 0.001), which remained significant after adjusting for prednisone dose (HR, 0.59; 95% CI, 0.42–0.83; p = 0.003). Fifty-two percent of relapses occurred while the patients were off maintenance therapy. Among all patients who relapsed on therapy, 52% of those receiving methotrexate were on |
| Databáze: | OpenAIRE |
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