Comparison of Phenotype and Outcome in Microscopic Polyangiitis Between Europe and Japan

Furuta, Shunsuke; Chaudhry, Afzal; Hamano, Yoshitomo; Fujimoto, Shouichi; Nagafuchi, Hiroko; Makino, Hírofumi; Matsuo, Seiichi; Ozaki, Shoichi; Endo, Tokiko; Muso, Eri; Ito, Chiharu; Kusano, Eiji; Yamagata, Masatsune; Ikeda, Kei; Kashiwakuma, Daisuke; Iwamoto, Itsuo; Westman, Kerstin; Jayne, David

doi:10.3899/jrheum.130602

Cited by 88 publications

(61 citation statements)

References 34 publications

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“…PF has been reported in 23% of GPA cases [52] and in 2.7–45% of MPA patients. In these cases, interstitial disease was usually identified at disease onset [7,11,17–20,48,53,54]. Importantly, there is a significant predominance of MPO-ANCA in published series, i.e., 46–71% of all cases compared to 0–29% for PR3-ANCA [13,27,51,52,54–56].…”

Section: Epidemiologymentioning

confidence: 99%

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Interstital lung disease in ANCA vasculitis

Alba

Flores‐Suárez

Henderson

et al. 2017

Autoimmunity Reviews

127

135

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Anti-neutrophil cytoplasmic antibodies (ANCA) vasculitides are immune-mediated disorders that primarily affect small blood vessels of the airway and kidneys. Lung involvement, one of the hallmarks of microscopic polyangiitis and granulomatosis with polyangiitis, is associated with increased mortality and morbidity. In recent years, several retrospective series and case reports have described the association of interstitial lung disease (ILD) and ANCA vasculitis, particularly those positive for ANCA specific for myeloperoxidase. In the majority of these patients pulmonary fibrosis occurs concurrently or predates the diagnosis of ANCA vasculitis. More importantly, these studies have shown that ILD has an adverse impact on the long-term prognosis of ANCA vasculitis. This review focuses on the main clinical and radiologic features of pulmonary fibrosis associated with anti-neutrophil cytoplasmic antibodies. Major histopathology features, prognosis and therapeutic options are summarized.

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Section: Epidemiologymentioning

confidence: 99%

“…Reasons for this particular association may include a higher prevalence of MPO-ANCA positivity and increased frequency of lung involvement and diffuse alveolar hemorrhage [11,61,62]. …”

Section: Epidemiologymentioning

confidence: 99%

Interstital lung disease in ANCA vasculitis

Alba

Flores‐Suárez

Henderson

et al. 2017

Autoimmunity Reviews

127

135

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“…Evolving treatment strategies have significantly improved survival and reduced morbidity for patients with AAV. Due to the rarity of AAV in childhood, much of our knowledge about outcomes, such as remission, relapse, and damage, has come from studies in adult disease (2)(3)(4)(5)(6)(7)(8)(9) or small pediatric case series (2,(10)(11)(12)(13)(14). Data from AAV studies in adults have shown remission rates as high as 90% (15) and 5-year survival rates of 80% (16).…”

mentioning

confidence: 99%

Early Outcomes in Children With Antineutrophil Cytoplasmic Antibody–Associated Vasculitis

Morishita

Moorthy

Lubieniecka

et al. 2017

Arthritis & Rheumatology

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“…Previous studies have shown that immunosuppressants are used only limitedly in Japanese patients with AAV (3, 24). In particular, CYC is not frequently used in Japan for patients with MPA/renal-limited vasculitis (RLV) (24, 25).…”

Section: Discussionmentioning

confidence: 99%

“…In particular, CYC is not frequently used in Japan for patients with MPA/renal-limited vasculitis (RLV) (24, 25). The relatively low use of AZA in Japan might be associated with this relatively infrequent use of CYC.…”

Section: Discussionmentioning

confidence: 99%

Azathioprine Intolerance in Japanese Patients with Antineutrophil Cytoplasmic Antibody-associated Vasculitis

et al. 2017

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Objective To assess the safety of azathioprine (AZA) in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Methods We retrospectively enrolled 67 consecutive AAV patients who had initiated AZA treatment from January 2006 to August 2014 at Okayama University Hospital. We evaluated the development of severe adverse events (AEs), AZA discontinuation due to total AEs (severe AEs included) within 1 year, and AZA-associated risk factors. Results The patients' median age was 70 years old. Forty-nine women and 18 men participated at the initiation of the study. Fifty-eight (87%) patients experienced AEs, and 36 experienced severe AEs (21 hepatic and 11 cytopenic severe AEs). Thirty-one (46%) patients discontinued treatment because of AEs. Abnormal hepatic laboratory test results at the treatment initiation were more frequent in patients with hepatic severe AEs and were associated with treatment discontinuation. The leukocyte and neutrophil counts at the treatment initiation were lower in the patients who discontinued treatment because of cytopenic AEs than in those who continued treatment. Only two patients experienced flare-ups during treatment. Conclusion The AE-associated AZA discontinuation rate in Japanese AAV patients was relatively high. AZA use warrants caution in patients with abnormal hepatic laboratory test results or low leukocyte or neutrophil counts.

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Comparison of Phenotype and Outcome in Microscopic Polyangiitis Between Europe and Japan

Abstract: Phenotypes in patients with MPA were different between Europe and Japan. However, the outcomes of patient survival and renal survival were similar.

Cited by 88 publications

References 34 publications

Interstital lung disease in ANCA vasculitis

Interstital lung disease in ANCA vasculitis

Early Outcomes in Children With Antineutrophil Cytoplasmic Antibody–Associated Vasculitis

Azathioprine Intolerance in Japanese Patients with Antineutrophil Cytoplasmic Antibody-associated Vasculitis

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