Wednesday, 17 Oct 2018

You are here

MPO Antibodies Predict Relapses in MPO-ANCA-Associated Vasculitis

A study of MPO-ANCA positive patients followed serially over 2 years shows that reappearance of MPO‐ANCA may predict  relapse in patients with MPO‐ANCA positive AAV and that routine MPO‐ANCA monitoring is warranted. 

This study aimed to establish a potential link between myeloperoxidase (MPO)‐antineutrophil cytoplasmic antibody (ANCA) and relapse in those with ANCA‐associated vasculitis (AAV). 

It is generally known that PR3-ANCA is generally associated with granulomatosis with polyangiitis (GPA), MPO-ANCA is regarded as a marker for microscopic polyangiitis (MPA)/renal-limited disease. While both are diagnostically important, their predictive value is less certain.  

From two Japanese cohort studies (477 patients),.271 were  MPO‐ANCA positive and met enrollment criteria. Of these, 183 had microscopic polyangiitis, 34 GPA, 15 with eosinophilic granulomatosis with polyangiitis, and 39 were unclassifiable.

In the vast majority, (72%) MPO‐ANCA levels decreased to normal levels within 6 months of treatment. 

Reappearance of MPO‐ANCA was seen in 73 (40%) of 181 patients with complete follow‐up data. Reappearance of MPO‐ANCA was more frequent in thos with a relapse (odds ratio = 26.2 [8.2–101], P < 0.0001) after adjusting for confounding factors.

Routine MPO‐ANCA monitoring should be implemented in patients with MPO AAV and this may be a useful biomarker for predicting relapse.

The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Teenage Obesity Increases Lupus Risk

Analysis of the Black Women's Health Study shows that obesity as a teenager may be associated with increased risk of systemic lupus erythematous (SLE) in adulthood.

The relationship between obesity and SLE risk is unclear. Past studies have predominantly assessed white women, while black women have higher prevalence of both obesity and SLE.

SLE-Scleroderma Overlap Outcomes

Overlap of autoimmune disorders represents a significant diagnostic and management challenge to the rheumatologist. A novel cohort analysis of overlap between systemic sclerosis (SSc) and systemic lupus erythematous (SLE) suggests such patients tend to be younger, more frequently have PAH, but less cutaneous manifestations of SSc.

Excess Mortality in CTD or Systemic Vasculitis Patients

The Norwegian connective tissue disease (CTD) and systemic vasculitis (PSV) registry (NOSVAR) studied patient outcomes over a 15 year period and found overall mortality to be higher in the CTD compared to the PSV group.

Mortality Improves in Lupus ESRD

The past two decades have seen a significant decline in mortality among patients with lupus nephritis, U.S. registry data indicated.

Ustekinumab May be Effective in Lupus

Ronald F van Vollenhoven and colleagues have reported in Lancet that ustekinumab (UST), an interleukin-12 and -23 inhibitor, when added to usual therapy in systemic lupus erythematosus (SLE) patients, was shown to be superior to placebo at improving clinical efficacy and laboratory parameters after 6 months of therapy.