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CLINICAL PRACTICE REVIEW AND META-ANALYSIS is a direct continuation of MEDICAL SCIENCE REVIEW. Title change reflects of expansion of the journal's scope of interest by meta-analysis manuscripts

Published: 2022-01-10



Antiproteinase-3 (PR3)-Antineutrophil Cytoplasmic Atibody (ANCA) as a Predictor for Relapse in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A Meta-Analysis

Jiaojiao Gong, Zhihui Quan, Ruiqiong Wang, Guotao Chen

Department of Nephrology, The Bishan Hospital of Chongqing, Chongqing, China (mainland)

Clin Prac Rev Met 2022; 9:e931261

DOI: 10.12659/CPRM.931261

BACKGROUND: Several predictive markers are related to the relapse of antineutrophil cytoplasmic antibody (ANCA)-associated small-vessel vasculitis (AAV). However, the conclusions are not definite, especially for antiproteinase-3 ANCA (PR3-ANCA). This study evaluated the value of PR3-ANCA in predicting relapse of AAV.
MATERIAL AND METHODS: Four databases (PubMed, Embase, Web of Science, and Cochrane Library) were searched. The cohort studies that assessed the factors associated with AAV relapse were included. Study quality was assessed using the Newcastle-Ottawa scale. The hazard ratios (HR) were analyzed using fixed-effects models. The sensitivity and publication bias analysis was performed to verify the reliability of the results.
RESULTS: A total of 14 studies, including 2761 participants, were evaluated in this meta-analysis. Fixed-effects pooling showed a significant association between PR3-ANCA and the relapse of AAV (pooled HR 1.829, 95% CI 1.591-2.103) compared to MPO (myeloperoxidase)-ANCA. In addition, AAV patients with lung involvement were 1.6 times more likely to have relapse (pooled HR 1.635, 95% CI 1.324-2.064) compared to those without lung involvement. The other factors, including age, sex, kidney-limited disease, granulomatosis with polyangiitis, upper respiratory involvement, and serum creatinine, could not predict AAV relapse according to the results of fixed-effects pooling.
CONCLUSIONS: PR3-ANCA and lung involvement could be used to predict occurrence of AAV relapse.

Keywords: Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, meta-analysis, Recurrence, SERPINB9 Protein, Human

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