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10.1002/art.39104 http://scihub22266oqcxt.onion/10.1002/art.39104 25776953!5956529!25776953     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=25776953&cmd=llinks): Failed to open stream: HTTP request failed! 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Outcomes of nonsevere relapses in antineutrophil cytoplasmic antibody-associated vasculitis treated with glucocorticoids |pdf=|usr=}}{{25776953}} gab.com Text Outcomes of nonsevere relapses in antineutrophil cytoplasmic antibody-associated vasculitis treated with glucocorticoids JO: Arthritis Rheumatol http://www.kidney.de/pget.php?&tw=1&pmid=25776953 #FOAvip OBJECTIVE: Nonsevere relapses are more common than severe relapses in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), but their clinical course and treatment outcomes remain largely unexamined. We undertook this study to analyze the outcomes of patients with nonsevere relapses in the Rituximab in ANCA-Associated Vasculitis (RAVE) trial who were treated with prednisone according to a prespecified protocol. METHODS: RAVE was a randomized, double-blind, placebo-controlled trial comparing rituximab (RTX) to cyclophosphamide (CYC) followed by azathioprine (AZA) for induction of remission. Patients who experienced nonsevere relapses between months 1 and 18 were treated with a prednisone increase without a concomitant change in their nonglucocorticoid immunosuppressants, followed by a taper. RESULTS: Forty-four patients with a first nonsevere relapse were analyzed. In comparison to the 71 patients who maintained relapse-free remission over 18 months, these patients were more likely to have proteinase 3-ANCAs, diagnoses of granulomatosis with polyangiitis (Wegener's), and a history of relapsing disease at baseline. A prednisone increase led to remission in 35 patients (80%). However, only 13 patients (30%) were able to maintain second remissions through the followup period (mean 12.5 months); 31 patients (70%) had a second disease relapse, 14 of them with severe disease. The mean time to second relapse was 9.4 months (4.7 months in the group treated with RTX versus 13.7 months in the group treated with CYC/AZA; P < 0.01). Patients who experienced nonsevere relapses received more glucocorticoids than those who maintained remission (6.7 grams versus 3.8 grams; P < 0.01). CONCLUSION: Treatment of nonsevere relapses in AAV with an increase in glucocorticoids is effective in restoring temporary remission in the majority of patients, but recurrent relapses within a relatively short interval remain common. Alternative treatment approaches are needed for this important subset of patients. Twit Text FOAVip Outcomes of nonsevere relapses in antineutrophil cytoplasmic antibody-associated vasculitis treated with glucocorticoids ????Arthritis Rheumatol http://www.kidney.de/pget.php?&tw=1&pmid=25776953 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=25776953 #FOAvip English Wikipedia <ref>{{Cite pmid|25776953}}</ref> Outcomes of nonsevere relapses in antineutrophil cytoplasmic antibody-associated vasculitis treated with glucocorticoids #MMPMID25776953 Miloslavsky EM; Specks U; Merkel PA; Seo P; Spiera R; Langford CA; Hoffman GS; Kallenberg CG; St Clair EW; Tchao NK; Ding L; Ikle D; Villareal M; Lim N; Brunetta P; Fervenza FC; Monach PA; Stone JH Arthritis Rheumatol 2015[Jun]; 67 (6): 1629-36 PMID25776953show ga OBJECTIVE: Nonsevere relapses are more common than severe relapses in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), but their clinical course and treatment outcomes remain largely unexamined. We undertook this study to analyze the outcomes of patients with nonsevere relapses in the Rituximab in ANCA-Associated Vasculitis (RAVE) trial who were treated with prednisone according to a prespecified protocol. METHODS: RAVE was a randomized, double-blind, placebo-controlled trial comparing rituximab (RTX) to cyclophosphamide (CYC) followed by azathioprine (AZA) for induction of remission. Patients who experienced nonsevere relapses between months 1 and 18 were treated with a prednisone increase without a concomitant change in their nonglucocorticoid immunosuppressants, followed by a taper. RESULTS: Forty-four patients with a first nonsevere relapse were analyzed. In comparison to the 71 patients who maintained relapse-free remission over 18 months, these patients were more likely to have proteinase 3-ANCAs, diagnoses of granulomatosis with polyangiitis (Wegener's), and a history of relapsing disease at baseline. A prednisone increase led to remission in 35 patients (80%). However, only 13 patients (30%) were able to maintain second remissions through the followup period (mean 12.5 months); 31 patients (70%) had a second disease relapse, 14 of them with severe disease. The mean time to second relapse was 9.4 months (4.7 months in the group treated with RTX versus 13.7 months in the group treated with CYC/AZA; P < 0.01). Patients who experienced nonsevere relapses received more glucocorticoids than those who maintained remission (6.7 grams versus 3.8 grams; P < 0.01). CONCLUSION: Treatment of nonsevere relapses in AAV with an increase in glucocorticoids is effective in restoring temporary remission in the majority of patients, but recurrent relapses within a relatively short interval remain common. Alternative treatment approaches are needed for this important subset of patients. |Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug therapy/immunology[MESH] |Antibodies, Monoclonal, Murine-Derived/therapeutic use[MESH] |Autoantibodies/immunology[MESH] |Azathioprine/therapeutic use[MESH] |Cyclophosphamide/therapeutic use[MESH] |Double-Blind Method[MESH] |Female[MESH] |Glucocorticoids/*therapeutic use[MESH] |Granulomatosis with Polyangiitis/*drug therapy/immunology[MESH] |Humans[MESH] |Immunosuppressive Agents/therapeutic use[MESH] |Maintenance Chemotherapy[MESH] |Male[MESH] |Microscopic Polyangiitis/*drug therapy/immunology[MESH] |Myeloblastin/immunology[MESH] |Peroxidase/immunology[MESH] |Prednisone/*therapeutic use[MESH] |Recurrence[MESH] |Remission Induction[MESH] |Rituximab[MESH] |Severity of Illness Index[MESH]Outcomes of nonsevere relapses in antineutrophil cytoplasmic antibody-(epmc).pdf DeepDyve Pubget Overpricing