期刊
BMC NEPHROLOGY
卷 20, 期 -, 页码 -出版社
BMC
DOI: 10.1186/s12882-019-1226-0
关键词
ANCA; Vasculitis; Methylprednisolone; Infection; Diabetes mellitus
资金
- Wellcome Trust research training fellowship [097962/Z/11/Z]
- NIH/NIDDK grant (Chapel Hill, USA) [P01DK058335]
- Wellcome Trust [097962/Z/11/Z] Funding Source: Wellcome Trust
BackgroundIntravenous pulse methylprednisolone (MP) is commonly included in the management of severe ANCA associated vasculitis (AAV) despite limited evidence of benefit. We aimed to evaluate outcomes in patients who had, or had not received MP, along with standard therapy for remission induction in severe AAV.MethodsWe retrospectively studied 114 consecutive patients from five centres in Europe and the United States with a new diagnosis of severe AAV (creatinine >500 mol/L or dialysis dependency) and that received standard therapy (plasma exchange, cyclophosphamide and high-dose oral corticosteroids) for remission induction with or without pulse MP between 2000 and 2013. We evaluated survival, renal recovery, relapses, and adverse events over the first 12months.ResultsFifty-two patients received pulse MP in addition to standard therapy compared to 62 patients that did not. There was no difference in survival, renal recovery or relapses. Treatment with MP associated with higher risk of infection during the first 3 months (hazard ratio (HR) 2.7, 95%CI [1.4-5.3], p=0.004) and higher incidence of diabetes (HR 6.33 [1.94-20.63], p=0.002), after adjustment for confounding factors.ConclusionsThe results of this study suggest that addition of pulse intravenous MP to standard therapy for remission induction in severe AAV may not confer clinical benefit and may be associated with more episodes of infection and higher incidence of diabetes.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据