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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Odler, B; Riedl, R; Gauckler, P; Shin, JI; Leierer, J; Merkel, PA; St, Clair, W; Fervenza, F; Geetha, D; Monach, P; Jayne, D; Smith, RM; Rosenkranz, A; Specks, U; Stone, JH; Kronbichler, A, , RAVE−ITN, Research, Group.
Risk factors for serious infections in ANCA-associated vasculitis.
Ann Rheum Dis. 2023; 82(5):681-687 Doi: 10.1136/ard-2022-223401 [OPEN ACCESS]
Web of Science PubMed PUBMED Central FullText FullText_MUG

 

Führende Autor*innen der Med Uni Graz
Odler Balazs
Co-Autor*innen der Med Uni Graz
Riedl Regina
Rosenkranz Alexander
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Abstract:
OBJECTIVES: Severe infections contribute to morbidity and mortality in antineutrophil cytoplasm antibody-associated vasculitis (AAV). This study aimed to identify risk factors associated with severe infections in participants of the Rituximab versus Cyclophosphamide for ANCA-Associated Vasculitis (RAVE) trial. METHODS: Data on 197 patients recruited into the RAVE trial were analysed. Participants received either rituximab (RTX) or cyclophosphamide (CYC), followed by azathioprine (AZA). Clinical and laboratory data of patients with and without severe infections (≥grade 3, according to the Common Terminology Criteria for Adverse Events version 3.0) were compared. Risk factors for severe infections were investigated using Cox-regression models. RESULTS: Eighteen of 22 (82%) severe infections occurred within 6 months after trial entry, most commonly respiratory tract infections (15/22, 68%). At baseline, lower absolute numbers of CD19+ cells were observed in patients with severe infections either receiving RTX or CYC/AZA at baseline, while CD5+B and CD3+T cells did not differ between groups. In Cox-regression analysis, higher baseline serum immunoglobulin M levels were associated with the risk of severe infections, whereby a higher baseline total CD19+B cell number and prophylaxis against Pneumocystis jirovecii with trimethoprim-sulfamethoxazole (TMP/SMX) with decreased risk of severe infections. Use of TMP/SMX was associated with lower risk of severe infections in both groups, receiving either RTX or CYC/AZA. CONCLUSIONS: The use of low-dose TMP/SMX is associated with reduced risk of severe infections in patients with AAV treated with either RTX or CYC/AZA. Reduced B cell subpopulations at start of treatment might be a useful correlate of reduced immunocompetence.
Find related publications in this database (using NLM MeSH Indexing)
Humans - administration & dosage
Rituximab - therapeutic use
Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use
Antibodies, Monoclonal, Murine-Derived - administration & dosage
Remission Induction - administration & dosage
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications, drug therapy
Cyclophosphamide - therapeutic use
Azathioprine - therapeutic use
Risk Factors - administration & dosage
Treatment Outcome - administration & dosage

Find related publications in this database (Keywords)
rituximab
cyclophosphamide
Infections
ANCA
Vasculitis
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