Risk factors associated with relapse in Japanese patients with microscopic polyangiitis

Takashi Wada, Akinori Hara, Yoshihiro Arimura, Ken Ei Sada, Hirofumi Makino, Koichi Amano, Satoshi Ito, Joichi Usui, Shunichi Kumagai, Shigeto Kobayashi, Yoshinari Takasaki, Kazuo Tanemoto, Hiroaki Dobashi, Masayoshi Harigai, Takao Fujii, Shouichi Fujimoto, Sakae Homma, Eri Muso, Yohko Murakawa, Hidehiro YamadaWako Yumura, Masaharu Yoshida

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective. We retrospectively studied the risk factors associated with relapse during remission maintenance therapy for myeloperoxidase-antineutrophil cytoplasmic autoantibody (MPO-ANCA)-positive microscopic polyangiitis (MPA). Methods. Sixty-two patients diagnosed with MPA according to the European Medicines Agency classification algorithm during a 2-year period from January 1, 2005, to December 31, 2006, and who achieved remission after the first remission-induction therapy, were examined (registration no. UMIN000001785). Results. The patient group comprised 25 men and 37 women aged 70.0 ± 8.9 years. The mean observation period was 30.2 ± 15.9 months. The rate of relapse was 24.2% (15/62), and mean interval between remission and relapse was 16.9 ± 13.5 months. During maintenance therapy following remission, the risk of relapse increased when the reduction rate of prednisolone increased above 0.8 mg/month (OR 12.6, 95% CI 2.2-97.9). Proteinuria at the start of maintenance therapy (regression coefficient 1.991 ± 0.758, p < 0.05) and the change in red blood cell counts in urine during the period from the start of maintenance therapy to the final observation (regression coefficient 0.126 ± 0.040, p < 0.01) were identified as risk factors influencing the vasculitis damage index. Conclusion. In Japan, relapse of MPO-ANCA-positive MPA may be associated with the reduction rate of oral prednisolone administration during maintenance therapy. The Journal of Rheumatology

Original languageEnglish
Pages (from-to)545-551
Number of pages7
JournalJournal of Rheumatology
Volume39
Issue number3
DOIs
Publication statusPublished - Mar 2012

Keywords

  • Antineutrophil cytoplasmic antibody
  • Microscopic polyangiitis
  • Relapse
  • Risk factors

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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  • Cite this

    Wada, T., Hara, A., Arimura, Y., Sada, K. E., Makino, H., Amano, K., Ito, S., Usui, J., Kumagai, S., Kobayashi, S., Takasaki, Y., Tanemoto, K., Dobashi, H., Harigai, M., Fujii, T., Fujimoto, S., Homma, S., Muso, E., Murakawa, Y., ... Yoshida, M. (2012). Risk factors associated with relapse in Japanese patients with microscopic polyangiitis. Journal of Rheumatology, 39(3), 545-551. https://doi.org/10.3899/jrheum.110705