Plasma Exchange and Glucocorticoids in Severe ANCA-Associated Vasculitis

Among patients with severe antineutrophil cytoplasmic antibody–associated vasculitis, plasma exchange did not reduce the incidence of death or end-stage kidney disease. A reduced-dose regimen of oral glucocorticoids was noninferior to a standard-dose regimen with respect to death or ESKD.

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Bibliographische Detailangaben
Veröffentlicht in:	The New England journal of medicine 2020-02, Vol.382 (7), p.622-631
Hauptverfasser:	Walsh, Michael, Merkel, Peter A, Peh, Chen-Au, Szpirt, Wladimir M, Puéchal, Xavier, Fujimoto, Shouichi, Hawley, Carmel M, Khalidi, Nader, Floßmann, Oliver, Wald, Ron, Girard, Louis P, Levin, Adeera, Gregorini, Gina, Harper, Lorraine, Clark, William F, Pagnoux, Christian, Specks, Ulrich, Smyth, Lucy, Tesar, Vladimir, Ito-Ihara, Toshiko, de Zoysa, Janak Rashme, Szczeklik, Wojciech, Flores-Suárez, Luis Felipe, Carette, Simon, Guillevin, Loïc, Pusey, Charles D, Casian, Alina L, Brezina, Biljana, Mazzetti, Andrea, McAlear, Carol A, Broadhurst, Elizabeth, Reidlinger, Donna, Mehta, Samir, Ives, Natalie, Jayne, David R.W
Format:	Artikel
Sprache:	eng
Schlagworte:	Administration, Oral Adult Aged Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - drug therapy Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - mortality Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - therapy Antineutrophil cytoplasmic antibodies Apheresis Clinical trials Combined Modality Therapy Cyclophosphamide Cyclophosphamide - therapeutic use Death Dose-Response Relationship, Drug End-stage renal disease Female Glomerular filtration rate Glucocorticoids Glucocorticoids - administration & dosage Glucocorticoids - adverse effects Hemorrhage Human health and pathology Humans Immunosuppressive Agents Immunosuppressive Agents - therapeutic use Incidence Induction Chemotherapy Kidney Diseases Kidney Diseases - complications Kidney Failure, Chronic Kidney Failure, Chronic - epidemiology Kidney Failure, Chronic - etiology Kidney Failure, Chronic - prevention & control Life Sciences Male Middle Aged Patients Plasma Plasma Exchange Plasma Exchange - adverse effects Quality of life Rituximab Rituximab - therapeutic use Statistical analysis Urology and Nephrology Vasculitis
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Beschreibung
Zusammenfassung:	Among patients with severe antineutrophil cytoplasmic antibody–associated vasculitis, plasma exchange did not reduce the incidence of death or end-stage kidney disease. A reduced-dose regimen of oral glucocorticoids was noninferior to a standard-dose regimen with respect to death or ESKD.
ISSN:	0028-4793 1533-4406
DOI:	10.1056/NEJMoa1803537