Arthritis Rheumatol:ANCA相关性血管炎中肺出血、PR3-ANCA阳性和尿红细胞管型与静脉血栓栓塞的关联

2019-06-25 xiangting MedSci原创

肺出血、PR3-ANCA阳性、心脏受累和存在红细胞管型的ANCA相关性血管炎患者发生VTEs的风险升高。

这项研究旨在评估利妥昔单抗治疗ANCA相关性血管炎(RAVE)试验中观察到的静脉血栓栓塞事件(VTEs)的发生率,并确定新的潜在危险因素。

对参加RAVE试验的197名患者的VTEs进行了分析。进行基线人口学、单因素和多因素分析以确定与ANCA相关性血管炎VTE相关的因素。

16例患者(8.1%)出现VTEs,总的发生事件时间为1.5个月(范围:1.0-2.75)。单因素分析确定了心脏受累(HR 17.408,95%CI 2.247-134.842)、蛋白酶3(PR3)-ANCA检测阳性(HR 7.731,95%CI 1.021-58.545)、肺出血(HR 3.889,95%CI 1.448-10.448)和存在红细胞管型(HR 15.617(3.491-69.854))与VTE发病有关。在多因素模型中,调整年龄和性别后,心脏受累(HR 21.836,95%CI 2.566-185.805)、PR3-ANCA阳性(HR 9.12,95%CI 1.158-71.839,p=0.036)、肺出血(HR 3.910,95%CI 1.453-10.522)和尿红细胞管型(16.455,95%CI 3.607-75.075)与VTE之间的关联仍有显著性。

肺出血、PR3-ANCA阳性、心脏受累和存在红细胞管型的ANCA相关性血管炎患者发生VTEs的风险升高。需要进一步的研究以确认和扩展这些发现,并探索这些患者高凝状态的机制,为潜在的治疗干预目标提供信息。

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    2019-12-16 xue8602
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    2019-12-01 fusion
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  5. 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  6. 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  7. 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  8. 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  9. 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    2019-06-27 zhaojie88
  10. 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    2019-06-27 Boyinsh

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使用贝利木单抗加硫唑嘌呤和糖皮质激素维持AAV缓解并不降低复发的风险。

Arthritis Rheumatol:ANCA相关性血管炎3个月和6个月的疾病活动性对长期预后的影响

该研究表明,3个月和6个月时的疾病状态可以预测AAV长期死亡率和ESRF的风险。

Ann Rheum Dis:霉酚酸酯与环磷酰胺在ANCA相关性血管炎缓解诱导上的比较

在AAV缓解诱导方面,MMF不逊于环磷酰胺,但复发率较高。

Ann Rheum Dis:利妥昔单抗的个体化定制与固定时间表方案维持ANCA相关性血管炎缓解的比较

利妥昔单抗的个体化定制和固定时间表方案的AAV复发率无显著差异。个体化定制组患者的利妥昔单抗输注次数较少。

Arthritis Rheumatol:B细胞耗竭疗法减弱ANCA相关性血管炎中的CD8+ T细胞应答

致病性B细胞-CD8+ T细胞轴的破坏有助于RTX在AAV中的疗效。需要进一步的研究来确定B细胞靶向治疗中CD8+ T细胞免疫监测的价值。