Disease Activity, Antineutrophil Cytoplasmic Antibody Type, and Lipid Levels in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis.
Adult
Aged
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
/ drug therapy
Antibodies, Antineutrophil Cytoplasmic
/ immunology
Antirheumatic Agents
/ therapeutic use
Apolipoprotein A-I
/ metabolism
Apolipoproteins B
/ metabolism
Azathioprine
/ therapeutic use
Blood Sedimentation
Cardiovascular Diseases
Cholesterol
/ metabolism
Cholesterol, HDL
/ metabolism
Cholesterol, LDL
/ metabolism
Cyclophosphamide
/ therapeutic use
Female
Humans
Lipid Metabolism
Male
Middle Aged
Myeloblastin
/ immunology
Peroxidase
/ immunology
Randomized Controlled Trials as Topic
Rituximab
/ therapeutic use
Severity of Illness Index
Journal
Arthritis & rheumatology (Hoboken, N.J.)
ISSN: 2326-5205
Titre abrégé: Arthritis Rheumatol
Pays: United States
ID NLM: 101623795
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
28
03
2019
accepted:
29
05
2019
pubmed:
5
6
2019
medline:
23
2
2020
entrez:
5
6
2019
Statut:
ppublish
Résumé
Patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) have an elevated risk of cardiovascular disease (CVD). This study was undertaken to develop a clearer understanding of the association between changes in disease activity and lipid levels in AAV, which may inform CVD risk stratification in this population. Lipid levels were assessed in stored serum samples (obtained at baseline and month 6) from the Rituximab for ANCA-Associated Vasculitis (RAVE) trial, which randomized patients to receive either rituximab or cyclophosphamide followed by azathioprine. Paired t-tests and multivariable linear regression were used to assess changes in lipid levels. Of the 142 patients with serum samples available, the mean ± SD age was 52.3 ± 14.7 years, 72 (51%) were male, 95 (67%) were proteinase 3 (PR3)-ANCA positive, 72 (51%) had received a new diagnosis of AAV, and 75 (53%) were treated with rituximab. Several lipid levels increased between baseline and month 6, including total cholesterol (+12.4 mg/dl [95% confidence interval (95% CI) +7.1, +21.0]), low-density lipoprotein (+10.3 mg/dl [95% CI +6.1, +17.1]), and apolipoprotein B (+3.5 mg/dl [95% CI +1.0, +8.3]). These changes were observed among newly diagnosed and PR3-ANCA-positive patients but not among those with relapsing disease or myeloperoxidase-ANCA-positive patients. There was no difference in change in lipid levels between rituximab-treated patients and cyclophosphamide-treated patients. Changes in lipid levels correlated with changes in erythrocyte sedimentation rate but not with other inflammatory markers or glucocorticoid exposure. Lipid levels increased during remission induction among patients with newly diagnosed AAV and those who were PR3-ANCA positive. Disease activity and ANCA type should be considered when assessing lipid profiles to stratify CVD risk in patients with AAV.
Identifiants
pubmed: 31162829
doi: 10.1002/art.41006
pmc: PMC6944270
mid: NIHMS1033536
doi:
Substances chimiques
Antibodies, Antineutrophil Cytoplasmic
0
Antirheumatic Agents
0
Apolipoprotein A-I
0
Apolipoproteins B
0
Cholesterol, HDL
0
Cholesterol, LDL
0
Rituximab
4F4X42SYQ6
Cyclophosphamide
8N3DW7272P
Cholesterol
97C5T2UQ7J
Peroxidase
EC 1.11.1.7
Myeloblastin
EC 3.4.21.76
Azathioprine
MRK240IY2L
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1879-1887Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR002548
Pays : United States
Organisme : NIAMS NIH HHS
ID : P60 AR047785
Pays : United States
Organisme : NIAMS NIH HHS
ID : L30 AR070520
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL127118
Pays : United States
Organisme : NIAMS NIH HHS
ID : U54 AR057319
Pays : United States
Organisme : NIAMS NIH HHS
ID : RC1 AR058303
Pays : United States
Organisme : Rheumatology Research Foundation
Pays : International
Organisme : NIAMS NIH HHS
ID : K23 AR073334
Pays : United States
Organisme : NCRR NIH HHS
ID : U54 RR019497
Pays : United States
Organisme : NINDS NIH HHS
ID : U54 NS064808
Pays : United States
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2019, American College of Rheumatology.
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