AB0625 Association between Cytomegalovirus Reactivation and Renal Prognosis during Remission Induction Therapy for ANCA-Associated Vasculitis
| العنوان: | AB0625 Association between Cytomegalovirus Reactivation and Renal Prognosis during Remission Induction Therapy for ANCA-Associated Vasculitis |
|---|---|
| المؤلفون: | K. Kawamori, N. Oguro, T. Kida, S. Omura, D. Nakagomi, K. Masatoshi, N. Takizawa, A. Nomura, K. Yuji, N. Kondo, Y. Yasuhiko, T. Yanagida, K. Endo, S. Hirata, K. Kawahata, K. Matsui, T. Takeuchi, K. Ichinose, M. Kato, R. Yanai, Y. Matsuo, Y. Shimojima, R. Nishioka, A. Yamasaki, T. Takata, T. Ito, M. Moriyama, A. Takatani, Y. Miyawaki, Y. Kawahito, T. Ito-Ihara, T. Kawaguchi, N. Yajima |
| المصدر: | Annals of the Rheumatic Diseases. 81:1439.1-1439 |
| بيانات النشر: | BMJ, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Rheumatology, Immunology, Immunology and Allergy, General Biochemistry, Genetics and Molecular Biology |
| الوصف: | BackgroundCytomegalovirus (CMV) has been associated with atherosclerosis in patients with chronic renal failure, and may cause secondary nephrotic syndrome. Therefore, we hypothesized that the reactivation of CMV by immunosuppressive therapy in patients with vasculitis may affect renal function.ObjectivesThe purpose of this study was to investigate relationships between CMV infection and renal function during ANCA-associated vasculitis remission induction therapy.MethodsThis retrospective cohort study enrolled microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), and eosinophilic granulomatosis with polyangiitis patients at 25 sites in Japan who had a first or severe relapse between January 2017 and June 2020. Of these, patients with MPA or GPA who had a positive renal lesion score on BVAS (version 3) at baseline, or vasculitis findings on renal biopsy, CMV assayed by 48 weeks of treatment, were included. Patients were divided into two groups based on the presence or absence of a positive CMV antigen test during the remission induction phase (0–48 weeks of treatment). Outcomes were the rate of change in estimated glomerular filtration rate (eGFR) at 48 weeks after initiation of treatment in both groups, as determined by (eGFR at 48 weeks - eGFR at the initiation of treatment)/eGFR at the initiation of treatment; where lower values were associated with worse renal function. General linear models adjusted for age, gender, presence of diabetes or chronic kidney disease, and the use of rituximab or cyclophosphamide were generated.ResultsA total of 387 patients had CMV antigen measured during ANCA-associated vasculitis treatment, of which 164 had renal involvement and eGFR measured at 48 weeks. Seventy-seven (47.0%) were male and the median age was 75 years (range 69–80 years). CMV reactivation was observed in 44 patients (26.8%). The beta coefficient of multiple regression analysis with CMV positive as 1 and negative as 0 was 0.08 (95% confidence interval -0.13 to 0.29) (p = 0.47). The rate of change in eGFR was higher in the CMV positive group, but not statistically significantly.ConclusionContrary to our hypothesis, renal prognoses tended to be better when CMV reactivation was observed. The patients in the CMV reactivation group may have been treated more aggressively, and some patients with a poor prognosis who were not followed up for 48 weeks dropped out. Further research investigating the adjustment of treatment methods is required.Disclosure of InterestsNone declared |
| تدمد: | 1468-2060 0003-4967 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::c42baa530f384664c728327a0e9cc0ae https://doi.org/10.1136/annrheumdis-2022-eular.3011 |
| رقم الأكسشن: | edsair.doi...........c42baa530f384664c728327a0e9cc0ae |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14682060 00034967 |
|---|