Rituximab, Cyclophosphamide, and Corticosteroids for ANCA Vasculitis: The Good, the Bad, and the Ugly.

Abstract:

BACKGROUNDS:ANCA-associated vasculitis (AAV) frequently present with a chronic relapsing course. Relapse leads to an increased need for therapeutic agents and consequent toxicity. SUMMARY:When referring to the available options for the management of AAV, the efficacy of glucocorticoids (GCs) is unquestionable. However, similarly unquestionable are their side effects. It has been more than 40 years since the efficacy of cyclophosphamide (CYC) as an add-on therapy to GCs in the management of necrotizing vasculitis has been proven. At the same time, concerns about the devastating side effects related to a prolonged exposure to this agent were raised. Despite the well-known side effects, the management of AAV remained centred on CYC until the early 2000s, when the pilot data first supporting the anecdotal efficacy of rituximab (RTX) were reported. However, it was not until 2010 that the non-inferiority of RTX to CYC for remission-induction in AAVs was demonstrated in 2 randomized controlled trials. Key Messages: Treatment of AAV has improved over the last decade, and currently available strategies are able to induce remission in the majority of the cases. Herewith, we aim to critically review available evidence and to critically address the following question: How can we reduce the GCs use the management of patients with AAV? Novel strategies that avoid the toxicity associated with currently used agents should be the goal. Ideally, these approaches should be GC-free.

journal_name

Kidney Blood Press Res

authors

Fenoglio R,Roccatello D,Sciascia S

doi

10.1159/000509608

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

784-791

issue

6

eissn

1420-4096

issn

1423-0143

pii

000509608

journal_volume

45

pub_type

杂志文章,评审
  • Clinical Significance of Crescent Formation in IgA Nephropathy - a Multicenter Validation Study.

    abstract:BACKGROUND/AIMS:Additional validation study was warranted to confirm the clinical significance of C score, which was recently added to the Oxford classification for immunoglobulin A nephropathy (IgAN). METHODS:We performed a multicenter retrospective cohort study in four hospitals in Korea. Patients who had biopsied g...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章,多中心研究

    doi:10.1159/000497808

    authors: Park S,Baek CH,Park SK,Kang HG,Hyun HS,Park E,Han SH,Ryu DR,Kim DK,Oh KH,Joo KW,Kim YS,Moon KC,Chin HJ,Lee H

    更新日期:2019-01-01 00:00:00

  • Long-term effect on blood pressure of early brief treatment by different antihypertensive agents: a study in the prague hypertensive rat.

    abstract::In the Prague hypertensive rat (PHR), a strain of genetic hypertension derived from Wistar, administration of various antihypertensive drugs (AHD) during the developmental phase of hypertension (weeks 5-9 of life) prevents the rise of blood pressure. However, only drugs blocking the renin-angiotensin system (RAS, i.e....

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000025898

    authors: Heller J,Hellerová S

    更新日期:1998-01-01 00:00:00

  • Effect of intrarenal infusion of angiotensin-(1-7) in the dog.

    abstract::Angiotensin-(1-7), (Ang-(1-7)), a metabolite of Ang II and /or Ang I, was infused into the renal artery (i.r.a) of anesthetized dogs in order to demonstrate its possible direct renal action. The dose administered, 15 Ig/kg BW/min in isotonic saline (0.072 ml/kg BW/min) throughout the experiment, did not influence the ...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000025959

    authors: Heller J,Kramer HJ,Malý J,Cervenka L,Horácek V

    更新日期:2000-01-01 00:00:00

  • Association Between Comprehensive Nutritional Scoring System (CNSS) and Outcomes of Continuous Ambulatory Peritoneal Dialysis Patients.

    abstract:BACKGROUND/AIMS:The presence of protein-energy wasting (PEW) among dialysis patients is a crucial risk factor for outcomes. The complicated pathogenesis of PEW makes it difficult to assess and treat. This single-center retrospective study focuses on the association between nutritional markers and the outcomes of contin...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000485926

    authors: Yan X,Yang X,Xie X,Xiang S,Zhang X,Shou Z,Chen J

    更新日期:2017-01-01 00:00:00

  • Effects of anemia and uremia and a combination of both on cardiovascular structures.

    abstract:BACKGROUND:Cardiovascular complications are a major cause of morbidity and mortality in chronic renal failure (CRF) patients. Chronic anemia is a complication of CRF and a cardiovascular risk factor per se. It was the aim of the present study to clarify whether uremia and anemia are additive or supra-additive with resp...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000317943

    authors: Jürgensen JS,Grimm R,Benz K,Philipp S,Eckardt KU,Amann K

    更新日期:2010-01-01 00:00:00

  • Low-flow polytetrafluoroethylene accesses: ultrasound surveillance and preemptive interventions ensure long-term patency.

    abstract:BACKGROUND:Vascular accesses (especially polytetrafluoroethylene grafts) with a permanently low flow (Qa <600 ml/min) are prone to thrombosis and thus have short patency. The reason for a permanently low flow is usually medial calcinosis of the inflow artery in diabetics. We retrospectively studied the long-term patenc...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000316702

    authors: Malik J,Tuka V,Chytilova E,Mokrejsova M,Masek M,Slavikova M

    更新日期:2010-01-01 00:00:00

  • Dialysis exercise team: the way to sustain exercise programs in hemodialysis patients.

    abstract::Patients affected by end-stage renal disease (ESRD) show quite lower physical activity and exercise capacity when compared to healthy individuals. In addition, a sedentary lifestyle is favoured by lack of a specific counseling on exercise implementation in the nephrology care setting. Increasing physical activity leve...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章,评审

    doi:10.1159/000355787

    authors: Capitanini A,Lange S,D'Alessandro C,Salotti E,Tavolaro A,Baronti ME,Giannese D,Cupisti A

    更新日期:2014-01-01 00:00:00

  • Effect of spironolactone on impaired fibrinolysis of hypertensive patients.

    abstract:BACKGROUND/AIMS:Angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists have beneficial effects on impaired fibrinolytic activity of hypertensive patients. The aim of the study was to evaluate the effect of antialdosterone treatment on impaired fibrinolysis of hypertensive patients. METHODS:Fo...

    journal_title:Kidney & blood pressure research

    pub_type: 临床试验,杂志文章

    doi:10.1159/000066348

    authors: Yalcin AI,Dincer M,Aslan V,Gulbas Z

    更新日期:2002-01-01 00:00:00

  • Interstitial pathomechanisms underlying progressive tubulointerstitial damage.

    abstract::Progressive renal disease poses an increasing problem for the medical community. Though the causes of end-stage renal failure are multiple, the histologic pictures of chronic renal disease are remarkably similar being characterized by interstitial infiltration, fibrosis, tubular atrophy and dilatation. This similarity...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章,评审

    doi:10.1159/000025911

    authors: Strutz F,Müller GA

    更新日期:1999-01-01 00:00:00

  • Effect of Ascorbic Acid on Mineral and Bone Disorders in Hemodialysis Patients: a Systematic Review and Meta-Analysis.

    abstract:BACKGROUND/AIMS:Hemodialysis (HD) patients often have inadequate nutrition, especially with respect to ascorbic acid (AA). It is reported that every HD session may cause a 50%- 75% decrease in plasma AA levels. Some studies have shown that supplementation of AA can change the outcome of chronic kidney disease-mineral b...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章,meta分析

    doi:10.1159/000493661

    authors: Ke G,Huang J,Zhu Y,Yang J,Zhang Y,Chen L,Hu J,Tao S,Hu Y,Yang D,Liu S

    更新日期:2018-01-01 00:00:00

  • Angiotensin II in the failing heart. Short communication.

    abstract::In the failing heart, the local angiotensin II concentration is increased, and the extent of cardiac angiotensin II release is related to the clinical signs of heart failure. The enzymes involved in myocardial generation of angiotensin II are the angiotensin-converting enzyme (ACE) and chymases. While myocardial angio...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章,评审

    doi:10.1159/000090189

    authors: Schulz R,Heusch G

    更新日期:2005-01-01 00:00:00

  • Pathophysiology of Post Transplant Hypertension in Kidney Transplant: Focus on Calcineurin Inhibitors Induced Oxidative Stress and Renal Sodium Retention and Implications with RhoA/Rho Kinase Pathway.

    abstract::Post-transplant hypertension is a common occurrence during treatment with calcineurin inhibitors (CNIs) in kidney transplant population. The pathogenesis of vasoconstriction induced by CNIs involves vascular tone alterations and kidney sodium transport regulation. Among the factors involved a key role is played by the...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000483023

    authors: Calò LA,Ravarotto V,Simioni F,Naso E,Marchini F,Bonfante L,Furian L,Rigotti P

    更新日期:2017-01-01 00:00:00

  • Everolimus retards cyst growth and preserves kidney function in a rodent model for polycystic kidney disease.

    abstract:BACKGROUND/AIMS:Rapamycin inhibits cyst growth in polycystic kidney disease by targeting the mammalian target of rapamycin (mTOR). To determine if this is a class effect of the mTOR inhibitors, we examined the effect of everolimus, the analogue of rapamycin, on disease progression in the Han:SPRD rat model of polycysti...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000104818

    authors: Wu M,Wahl PR,Le Hir M,Wackerle-Men Y,Wuthrich RP,Serra AL

    更新日期:2007-01-01 00:00:00

  • Impacts of changes in obesity parameters for the prediction of blood pressure change in Japanese individuals.

    abstract:AIMS AND METHODS:By analyzing data from 2,861 individuals who underwent general health screening 2 years running, we have investigated the impact of changes in waist circumference (WC) and body mass index (BMI) over a 1-year period on systolic blood pressure (BPs). We termed WC, BMI, and BPs at the first visit as WC1, ...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000264233

    authors: Ishizaka N,Ishizaka Y,Toda E,Koike K,Yamakado M,Nagai R

    更新日期:2009-01-01 00:00:00

  • Downregulation of peptide transporters PEPT1 and PEPT2 by oxidative stress responsive kinase OSR1.

    abstract:BACKGROUND/AIMS:OSR1 (oxidative-stress-responsive kinase 1) participates in the regulation of renal tubular ion transport, cell volume and blood pressure. Whether OSR1 contributes to the regulation of organic solute transport remained; however, elusive. The present study thus explored the OSR1 sensitivity of the peptid...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000368469

    authors: Warsi J,Elvira B,Bissinger R,Shumilina E,Hosseinzadeh Z,Lang F

    更新日期:2014-01-01 00:00:00

  • The association between peritoneal charge barrier dysfunction and protein lost during continuous ambulatory peritoneal dialysis.

    abstract:BACKGROUND/AIMS:The main purpose of the present study was to determine the effect of peritoneal charge barrier dysfunction on hypoalbuminemia during CAPD. METHODS:We measured the association of dialysis dose, peritoneal equilibration test (PET) results (ratio of dialysate and plasma creatinine), and peritoneal charge ...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000350150

    authors: Yu GQ,Chen J,Li JX

    更新日期:2013-01-01 00:00:00

  • Determination of procalcitonin levels in patients with nephropathia epidemica - a useful tool or an unnecessary diagnostic procedure?

    abstract:BACKGROUND/AIMS:Puumala virus causes nephropathia epidemica (NE), a milder form of hemorrhagic fever with renal syndrome that occurs in Central and Northern Europe. Several studies have sought to identify risk factors for severe NE. However, elevated procalcitonin (PCT) levels have not previously been investigated as a...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000368479

    authors: Latus J,Kitterer D,Segerer S,Artunc F,Alscher MD,Braun N

    更新日期:2015-01-01 00:00:00

  • Non-random distribution and sensory functions of primary cilia in vascular smooth muscle cells.

    abstract::Although primary cilia are increasingly recognized to play sensory roles in several cellular systems, their role in vascular smooth muscle cells (VSMCs) has not been defined. We examined in situ position/orientation of primary cilia and ciliary proteins in VSMCs and tested the hypothesis that primary cilia of VSMCs ex...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000132462

    authors: Lu CJ,Du H,Wu J,Jansen DA,Jordan KL,Xu N,Sieck GC,Qian Q

    更新日期:2008-01-01 00:00:00

  • Activation of Nrf2/HO-1 Pathway by Glycogen Synthase Kinase-3β Inhibition Attenuates Renal Ischemia/Reperfusion Injury in Diabetic Rats.

    abstract:BACKGROUND/AIMS:Diabetes mellitus can exacerbate renal ischemia-reperfusion (I/R) injury (RI/RI). The aim of the present study was to evaluate the protective effect of GSK-3β inhibition (TDZD-8) on I/R-induced renal injury through the Nrf2/HO-1 pathway in a streptozocin (STZ)-induced diabetic rat model. METHODS:STZ-in...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000477947

    authors: Shen X,Hu B,Xu G,Chen F,Ma R,Zhang N,Liu J,Ma X,Zhu J,Wu Y,Shen R

    更新日期:2017-01-01 00:00:00

  • Urinary angiotensin converting enzyme 2 increases in patients with type 2 diabetic mellitus.

    abstract:BACKGROUND/AIMS:Angiotensin converting enzyme 2 (ACE2) is highly expressed in the kidney and recognized to be renoprotective by degrading Angiotensin II to Angiotensin (1-7) in diabetic nephropathy. However, little is known about the role of urinary ACE2 (UACE2) in diabetes. The present study was performed to evaluate ...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000368486

    authors: Liang Y,Deng H,Bi S,Cui Z,A L,Zheng D,Wang Y

    更新日期:2015-01-01 00:00:00

  • How to calculate clearance of highly protein-bound drugs during continuous venovenous hemofiltration demonstrated with flucloxacillin.

    abstract:BACKGROUND:Flucloxacillin is an important antimicrobial drug in the treatment of infections with Staphylococcus aureus and therefore is often used in staphylococcal infections. Furthermore, flucloxacillin has a high protein binding rate as for example ceftriaxone or teicoplanin--drugs which have formerly been character...

    journal_title:Kidney & blood pressure research

    pub_type: 临床试验,杂志文章

    doi:10.1159/000070997

    authors: Meyer B,Ahmed el Gendy S,Delle Karth G,Locker GJ,Heinz G,Jaeger W,Thalhammer F

    更新日期:2003-01-01 00:00:00

  • High Mobility Group Box1 Inhibitor Glycyrrhizic Acid Attenuates Kidney Injury in Streptozotocin-Induced Diabetic Rats.

    abstract:BACKGROUND/AIMS:High mobility group box 1 (HMGB1) is an important mediator of the inflammatory response. It has been implicated in the pathogenesis of autoimmune diseases, atherosclerosis, and obesity. However, the effects of HMGB1 on diabetic nephropathy remain unclear. Here, we investigated the potential roles and me...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000485045

    authors: Zhang H,Zhang R,Chen J,Shi M,Li W,Zhang X

    更新日期:2017-01-01 00:00:00

  • Effects of spironolactone in combination with angiotensin-converting enzyme inhibitors or Angiotensin receptor blockers in patients with proteinuria.

    abstract:BACKGROUND/AIMS:This study aimed to investigate the potential beneficial anti-proteinuric effect of an add-on aldosterone blockade and the impact of the aldosterone escape phenomenon. METHODS:We retrospectively analyzed data of 304 patients with persistent proteinuria, who were administered spironolactone (25 mg/day) ...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000368470

    authors: Kim HY,Bae EH,Ma SK,Kim SW

    更新日期:2014-01-01 00:00:00

  • Hypertension and dialysis.

    abstract::The high mortality rate seen in dialysis patients is related to long-standing high blood pressure and the presence of other traditional as well as non-traditional risk factors for cardiovascular disease. Hypertension is associated with increased risk for left ventricular hypertrophy, coronary artery disease, congestiv...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章,评审

    doi:10.1159/000070987

    authors: Hörl MP,Hörl WH

    更新日期:2003-01-01 00:00:00

  • Protective effect of dexpanthenol on ischemia-reperfusion-induced renal injury in rats.

    abstract:BACKGROUND/AIMS:This experimental study was designed to investigate protective and therapeutic effects of Dexpanthenol (Dxp), an alcoholic analogue of pantothenic acid, on kidney damage induced by ischemia-reperfusion (I/R) in rats. METHODS:Forty rats were randomly divided into a control group and 4 I/R groups (1 h is...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000343411

    authors: Altintas R,Parlakpinar H,Beytur A,Vardi N,Polat A,Sagir M,Odabas GP

    更新日期:2012-01-01 00:00:00

  • Suppressed activities of cathepsins and metalloproteinases in the chronic model of puromycin aminonucleoside nephrosis.

    abstract::Glomerulosclerosis and tubulointerstitial fibrosis are the hallmarks of chronic renal diseases. In the present study, we have investigated the potential involvement of various proteinases in these alterations in the model of puromycin aminonucleoside (PAN) nephrosis. Two groups of male Wistar rats were given either th...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000025917

    authors: Huang S,Schaefer RM,Reisch S,Paczek L,Schaefer L,Teschner M,Sebekova K,Heidland A

    更新日期:1999-01-01 00:00:00

  • The Th1 and Th2 paradigm in ANCA-associated vasculitis.

    abstract::In the pathogenesis of anti-neutrophil cytoplasm antibodies (ANCA)-associated vasculitis, T cell contribution is indicated by T cell-dependent ANCA production combined with the presence of T cells in inflammatory infiltrates. However, the exact pathogenic role of T cells in ANCA-associated vasculitis remains to be det...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章,评审

    doi:10.1159/000072987

    authors: Sanders JS,Stegeman CA,Kallenberg CG

    更新日期:2003-01-01 00:00:00

  • Chlamydia pneumoniae and atherosclerosis: no way-out or long way? What about renal failure patients?

    abstract::Recently, Chlamydia pneumoniae is the microorganism frequently implicated in the infection-based inflammatory atherogenous hypothesis. Although in vitro experimental data and initial sero-epidemiologic, pathology-based studies and antibiotic trials supported this interesting hypothesis, later data are conflicting. Som...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章,评审

    doi:10.1159/000078146

    authors: Tsirpanlis G

    更新日期:2004-01-01 00:00:00

  • Loss of the Protein Cystathionine β-Synthase During Kidney Injury Promotes Renal Tubulointerstitial Fibrosis.

    abstract:BACKGROUND/AIMS:Renal tubulointerstitial fibrosis (TIF) is the common pathway of progressive chronic kidney disease. Inflammation has been widely accepted as the major driving force of TIF. Cystathionine β-synthase (CBS) is the first and rate-limiting enzyme in the transsulfuration pathway. CBS is considered to play pr...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000479295

    authors: Yuan X,Zhang J,Xie F,Tan W,Wang S,Huang L,Tao L,Xing Q,Yuan Q

    更新日期:2017-01-01 00:00:00

  • IgA nephropathy in Czech patients--are we able reliably predict the outcome?

    abstract:BACKGROUND/AIMS:The aim of our study was to retrospectively analyse data of 520 Czech patients with IgA nephropathy (IgAN) and to specify the risk factors affecting renal survival of IgAN patients. METHODS:Cox proportional hazards regression model was used to evaluate the effects of different variables on renal surviv...

    journal_title:Kidney & blood pressure research

    pub_type: 杂志文章

    doi:10.1159/000368467

    authors: Maixnerova D,Neprasova M,Skibova J,Mokrisova J,Rysava R,Reiterova J,Jancova E,Merta M,Zadrazil J,Honsova E,Tesar V

    更新日期:2014-01-01 00:00:00