Long-term Outcome and Efficacy of Cyclophosphamide Therapy in Japanese Patients with ANCA-associated Microscopic Polyangiitis: A Retrospective Study

Izaya Nakaya, Mayumi Yahata, Satoko Takahashi, Tomomi Sasajima, Tsutomu Sakuma, Yugo Shibagaki, Jun Soma
2013 Internal medicine (Tokyo. 1992)  
Objective The aim of this study was to elucidate the efficacy of cyclophosphamide (CY) in Japanese patients with antineutrophil cystoplasmic antibody (ANCA)-associated microscopic polyangiitis (MPA). Methods Sixty-four patients, newly diagnosed with ANCA-associated MPA were included in this retrospective study. The patients were divided into two groups based on whether they received combination therapy of CY and corticosteroid (CS) (CY group, n=29) or CS alone (CS group, n=35) for remission
more » ... ) for remission induction. The primary outcome was all-cause mortality. Results Most patients in the CY group were treated with oral CY. Between the two groups, there were no differences in the baseline characteristics except for a higher proportion of male patients in the CY group. The remission rate was not substantially different between the two groups (86.2% in the CY group vs. 91.4% in the CS group). The survival rate was slightly higher in the CY group than in the CS group (not statistically significant; 0.86 vs. 0.77 at 1 year and 0.73 vs. 0.64 at 5 years, p=0.648). In the CY group, the hazard ratio after adjusting for age, sex, Birmingham vasculitis activity score values, serum albumin levels and Creactive protein (CRP) levels was 0.657 (95% CI, 0.254-1.699; p=0.386). Conclusion We observed no increased efficacy of CY in ANCA-positive MPA in the Japanese patients, and hence, its efficacy may be limited in these patients.
doi:10.2169/internalmedicine.52.0199 pmid:24240788 fatcat:etnjthhjufgfpcc3j7zialt5xy