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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