Overall survival, renal survival and relapse in patients with microscopic polyangiitis: a systematic review of current evidence
Objective. There are limited data on the long-term prognosis of microscopic polyangiitis (MPA). A systematic review was performed to estimate the survival, renal survival and relapse rates in patients with MPA. Methods. Articles included in MEDLINE and EMBASE databases were reviewed. Randomized or n...
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| Veröffentlicht in: | Rheumatology (Oxford, England) England), 2011-08, Vol.50 (8), p.1414-1423 |
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| creator | Corral-Gudino, Luis Borao-Cengotita-Bengoa, María del Pino-Montes, Javier Lerma-Márquez, José L. |
| description | Objective. There are limited data on the long-term prognosis of microscopic polyangiitis (MPA). A systematic review was performed to estimate the survival, renal survival and relapse rates in patients with MPA.
Methods. Articles included in MEDLINE and EMBASE databases were reviewed. Randomized or non-randomized trials, cohort, case-control and cases-series studies of patients with MPA diagnosed according to Chapel Hill Consensus Conference definitions, a high rate of biopsy-confirmed diagnosis, follow-up >1 year and follow-up losses |
| doi_str_mv | 10.1093/rheumatology/ker112 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_876242216</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/rheumatology/ker112</oup_id><sourcerecordid>876242216</sourcerecordid><originalsourceid>FETCH-LOGICAL-c418t-21eafa535f9660b4ebc672e2868dfebd5f7dc50d3bd2142dcd0e9c152074a2c63</originalsourceid><addsrcrecordid>eNqNkE9P3DAQxa2qqFDaT4CEfKl66YL_xcn2hlBbKiFxgXM0sSdgcOLUdhbtia-OV7tAj5xsP__mzcwj5IizE86W8jTe4TxADj7crk8fMHIuPpADrrRYMCnFx9e7UPvkc0r3jLGKy-YT2RdcMa10fUCerlYYwXua5rhyK_A_aMQR3t4URlskD1NC6kY6QXY45kQfXb6jgzMxJBMmZ-gU_BrGW-eySz8p0LROGcuA5SviyuEjDT01cyz-mRbB4mjwC9nrwSf8ujsPyc3vX9fnF4vLqz9_z88uF0bxJi8ER-ihklW_1Jp1Cjuja4Gi0Y3tsbNVX1tTMSs7W3YT1liGS8MrwWoFwmh5SL5vfacY_s2Ycju4ZNB7GDHMqW1qLZQQfEPKLbnZLEXs2ym6AeK65azdBN_-H3y7Db5UHe_8525A-1rzknQBvu0ASAZ8H2E0Lr1xSlaNkqxwJ1suzNO7Oj8DiMulBQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>876242216</pqid></control><display><type>article</type><title>Overall survival, renal survival and relapse in patients with microscopic polyangiitis: a systematic review of current evidence</title><source>MEDLINE</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Corral-Gudino, Luis ; Borao-Cengotita-Bengoa, María ; del Pino-Montes, Javier ; Lerma-Márquez, José L.</creator><creatorcontrib>Corral-Gudino, Luis ; Borao-Cengotita-Bengoa, María ; del Pino-Montes, Javier ; Lerma-Márquez, José L.</creatorcontrib><description>Objective. There are limited data on the long-term prognosis of microscopic polyangiitis (MPA). A systematic review was performed to estimate the survival, renal survival and relapse rates in patients with MPA.
Methods. Articles included in MEDLINE and EMBASE databases were reviewed. Randomized or non-randomized trials, cohort, case-control and cases-series studies of patients with MPA diagnosed according to Chapel Hill Consensus Conference definitions, a high rate of biopsy-confirmed diagnosis, follow-up >1 year and follow-up losses <10%. Two independent authors using a predefined questionnaire for evaluating the quality and risk of bias for each study extracted data.
Results. Eighteen studies for MPA prognosis (n = 940) and six for MPA outcomes after transplantation (n = 65) were included. Survival rates were 77-100% at 1 year, 46-80% at 5 years and 60-80% at 10 years. Higher mortality density occurred within the first months after diagnosis. Vasculitis was the cause of death in 32-50% of patients. Relapses were detected in 19-39% of cases (median time to relapse 15-43 months). Renal graft survival was 85-94% at 1 year and 51-87% at 5 years. Age, renal involvement and immunosuppressive treatment were related to mortality. Lower relapse rate was achieved with 12 vs 6 CYC pulses.
Conclusion. Evidence regarding MPA prognosis is weak. MPA mortality is mainly concentrated in the first months after diagnosis. Fewer than 50% of deaths are related to MPA activity. MPA long-term prognosis is less severe, although relapses are frequent. End-stage renal failure is a frequent complication of MPA, and renal transplantation could be an effective therapy in these patients. Early diagnosis, early initiation of a tailored therapy according to risk factors and a longer follow-up of the patients are needed.</description><identifier>ISSN: 1462-0324</identifier><identifier>EISSN: 1462-0332</identifier><identifier>DOI: 10.1093/rheumatology/ker112</identifier><identifier>PMID: 21406467</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Biological and medical sciences ; Cause of Death ; Databases, Bibliographic ; Diseases of the osteoarticular system ; Humans ; Kidney Transplantation - mortality ; Medical sciences ; Microscopic Polyangiitis - diagnosis ; Microscopic Polyangiitis - mortality ; Prognosis ; Randomized Controlled Trials as Topic ; Recurrence ; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis ; Survival Rate ; Time Factors</subject><ispartof>Rheumatology (Oxford, England), 2011-08, Vol.50 (8), p.1414-1423</ispartof><rights>The Author 2011. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com 2011</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c418t-21eafa535f9660b4ebc672e2868dfebd5f7dc50d3bd2142dcd0e9c152074a2c63</citedby><cites>FETCH-LOGICAL-c418t-21eafa535f9660b4ebc672e2868dfebd5f7dc50d3bd2142dcd0e9c152074a2c63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24358430$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21406467$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Corral-Gudino, Luis</creatorcontrib><creatorcontrib>Borao-Cengotita-Bengoa, María</creatorcontrib><creatorcontrib>del Pino-Montes, Javier</creatorcontrib><creatorcontrib>Lerma-Márquez, José L.</creatorcontrib><title>Overall survival, renal survival and relapse in patients with microscopic polyangiitis: a systematic review of current evidence</title><title>Rheumatology (Oxford, England)</title><addtitle>Rheumatology (Oxford)</addtitle><description>Objective. There are limited data on the long-term prognosis of microscopic polyangiitis (MPA). A systematic review was performed to estimate the survival, renal survival and relapse rates in patients with MPA.
Methods. Articles included in MEDLINE and EMBASE databases were reviewed. Randomized or non-randomized trials, cohort, case-control and cases-series studies of patients with MPA diagnosed according to Chapel Hill Consensus Conference definitions, a high rate of biopsy-confirmed diagnosis, follow-up >1 year and follow-up losses <10%. Two independent authors using a predefined questionnaire for evaluating the quality and risk of bias for each study extracted data.
Results. Eighteen studies for MPA prognosis (n = 940) and six for MPA outcomes after transplantation (n = 65) were included. Survival rates were 77-100% at 1 year, 46-80% at 5 years and 60-80% at 10 years. Higher mortality density occurred within the first months after diagnosis. Vasculitis was the cause of death in 32-50% of patients. Relapses were detected in 19-39% of cases (median time to relapse 15-43 months). Renal graft survival was 85-94% at 1 year and 51-87% at 5 years. Age, renal involvement and immunosuppressive treatment were related to mortality. Lower relapse rate was achieved with 12 vs 6 CYC pulses.
Conclusion. Evidence regarding MPA prognosis is weak. MPA mortality is mainly concentrated in the first months after diagnosis. Fewer than 50% of deaths are related to MPA activity. MPA long-term prognosis is less severe, although relapses are frequent. End-stage renal failure is a frequent complication of MPA, and renal transplantation could be an effective therapy in these patients. Early diagnosis, early initiation of a tailored therapy according to risk factors and a longer follow-up of the patients are needed.</description><subject>Biological and medical sciences</subject><subject>Cause of Death</subject><subject>Databases, Bibliographic</subject><subject>Diseases of the osteoarticular system</subject><subject>Humans</subject><subject>Kidney Transplantation - mortality</subject><subject>Medical sciences</subject><subject>Microscopic Polyangiitis - diagnosis</subject><subject>Microscopic Polyangiitis - mortality</subject><subject>Prognosis</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Recurrence</subject><subject>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis</subject><subject>Survival Rate</subject><subject>Time Factors</subject><issn>1462-0324</issn><issn>1462-0332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE9P3DAQxa2qqFDaT4CEfKl66YL_xcn2hlBbKiFxgXM0sSdgcOLUdhbtia-OV7tAj5xsP__mzcwj5IizE86W8jTe4TxADj7crk8fMHIuPpADrrRYMCnFx9e7UPvkc0r3jLGKy-YT2RdcMa10fUCerlYYwXua5rhyK_A_aMQR3t4URlskD1NC6kY6QXY45kQfXb6jgzMxJBMmZ-gU_BrGW-eySz8p0LROGcuA5SviyuEjDT01cyz-mRbB4mjwC9nrwSf8ujsPyc3vX9fnF4vLqz9_z88uF0bxJi8ER-ihklW_1Jp1Cjuja4Gi0Y3tsbNVX1tTMSs7W3YT1liGS8MrwWoFwmh5SL5vfacY_s2Ycju4ZNB7GDHMqW1qLZQQfEPKLbnZLEXs2ym6AeK65azdBN_-H3y7Db5UHe_8525A-1rzknQBvu0ASAZ8H2E0Lr1xSlaNkqxwJ1suzNO7Oj8DiMulBQ</recordid><startdate>20110801</startdate><enddate>20110801</enddate><creator>Corral-Gudino, Luis</creator><creator>Borao-Cengotita-Bengoa, María</creator><creator>del Pino-Montes, Javier</creator><creator>Lerma-Márquez, José L.</creator><general>Oxford University Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110801</creationdate><title>Overall survival, renal survival and relapse in patients with microscopic polyangiitis: a systematic review of current evidence</title><author>Corral-Gudino, Luis ; Borao-Cengotita-Bengoa, María ; del Pino-Montes, Javier ; Lerma-Márquez, José L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c418t-21eafa535f9660b4ebc672e2868dfebd5f7dc50d3bd2142dcd0e9c152074a2c63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Biological and medical sciences</topic><topic>Cause of Death</topic><topic>Databases, Bibliographic</topic><topic>Diseases of the osteoarticular system</topic><topic>Humans</topic><topic>Kidney Transplantation - mortality</topic><topic>Medical sciences</topic><topic>Microscopic Polyangiitis - diagnosis</topic><topic>Microscopic Polyangiitis - mortality</topic><topic>Prognosis</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Recurrence</topic><topic>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis</topic><topic>Survival Rate</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Corral-Gudino, Luis</creatorcontrib><creatorcontrib>Borao-Cengotita-Bengoa, María</creatorcontrib><creatorcontrib>del Pino-Montes, Javier</creatorcontrib><creatorcontrib>Lerma-Márquez, José L.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Rheumatology (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Corral-Gudino, Luis</au><au>Borao-Cengotita-Bengoa, María</au><au>del Pino-Montes, Javier</au><au>Lerma-Márquez, José L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Overall survival, renal survival and relapse in patients with microscopic polyangiitis: a systematic review of current evidence</atitle><jtitle>Rheumatology (Oxford, England)</jtitle><addtitle>Rheumatology (Oxford)</addtitle><date>2011-08-01</date><risdate>2011</risdate><volume>50</volume><issue>8</issue><spage>1414</spage><epage>1423</epage><pages>1414-1423</pages><issn>1462-0324</issn><eissn>1462-0332</eissn><abstract>Objective. There are limited data on the long-term prognosis of microscopic polyangiitis (MPA). A systematic review was performed to estimate the survival, renal survival and relapse rates in patients with MPA.
Methods. Articles included in MEDLINE and EMBASE databases were reviewed. Randomized or non-randomized trials, cohort, case-control and cases-series studies of patients with MPA diagnosed according to Chapel Hill Consensus Conference definitions, a high rate of biopsy-confirmed diagnosis, follow-up >1 year and follow-up losses <10%. Two independent authors using a predefined questionnaire for evaluating the quality and risk of bias for each study extracted data.
Results. Eighteen studies for MPA prognosis (n = 940) and six for MPA outcomes after transplantation (n = 65) were included. Survival rates were 77-100% at 1 year, 46-80% at 5 years and 60-80% at 10 years. Higher mortality density occurred within the first months after diagnosis. Vasculitis was the cause of death in 32-50% of patients. Relapses were detected in 19-39% of cases (median time to relapse 15-43 months). Renal graft survival was 85-94% at 1 year and 51-87% at 5 years. Age, renal involvement and immunosuppressive treatment were related to mortality. Lower relapse rate was achieved with 12 vs 6 CYC pulses.
Conclusion. Evidence regarding MPA prognosis is weak. MPA mortality is mainly concentrated in the first months after diagnosis. Fewer than 50% of deaths are related to MPA activity. MPA long-term prognosis is less severe, although relapses are frequent. End-stage renal failure is a frequent complication of MPA, and renal transplantation could be an effective therapy in these patients. Early diagnosis, early initiation of a tailored therapy according to risk factors and a longer follow-up of the patients are needed.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>21406467</pmid><doi>10.1093/rheumatology/ker112</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Biological and medical sciences Cause of Death Databases, Bibliographic Diseases of the osteoarticular system Humans Kidney Transplantation - mortality Medical sciences Microscopic Polyangiitis - diagnosis Microscopic Polyangiitis - mortality Prognosis Randomized Controlled Trials as Topic Recurrence Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis Survival Rate Time Factors |
| title | Overall survival, renal survival and relapse in patients with microscopic polyangiitis: a systematic review of current evidence |
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