Open AccessPlasma exchange and glucocorticoids to delay death or end-stage renal disease in anti-neutrophil cytoplasm antibody-associated vasculitis: PEXIVAS non-inferiority factorial RCT
Author(s) -
David Jayne,
Michael Walsh,
Peter A. Merkel,
Chen Au Peh,
Wladimir Szpirt,
Xavier Puéchal,
Shouichi Fujimoto,
Carmel M. Hawley,
Nader Khalidi,
Rachel Jones,
Oliver Floßmann,
Ron Wald,
Louis Girard,
Adeera Levin,
Gina Gregorini,
Lorraine Harper,
William F. Clark,
Christian Pagnoux,
Ulrich Specks,
Lucy Smyth,
Toshiko ItoIhara,
Janak de Zoysa,
Biljana Brezina,
Andrea Mazzetti,
Carol A. McAlear,
Donna Reidlinger,
Samir Mehta,
Natalie Ives,
Elizabeth Brettell,
Hugh Jarrett,
Keith Wheatley,
Elizabeth Broadhurst,
Alina Casian,
Charles D. Pusey
Publication year - 2022
Publication title -
hta on dvd/health technology assessment
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.426
H-Index - 126
eISSN - 2046-4924
pISSN - 1366-5278
DOI - 10.3310/pnxb5040
Subject(s) - medicine , microscopic polyangiitis , anti neutrophil cytoplasmic antibody , vasculitis , rituximab , azathioprine , autoantibody , immunology , prednisolone , regimen , gastroenterology , antibody , disease
Anti-neutrophil cytoplasm antibody-associated vasculitis is a multisystem, autoimmune disease that causes organ failure and death. Physical removal of pathogenic autoantibodies by plasma exchange is recommended for severe presentations, along with high-dose glucocorticoids, but glucocorticoid toxicity contributes to morbidity and mortality. The lack of a robust evidence base to guide the use of plasma exchange and glucocorticoid dosing contributes to variation in practice and suboptimal outcomes.