Prevention of relapses in Wegener's granulomatosis by treatment based on antineutrophil cytoplasmic antibody titre

• Published in: The Lancet (British edition) Vol. 336; no. 8717; p. 709
• Main Authors: Tervaert, J W, Huitema, M G, Hené, R J, Sluiter, W J, The, T H, van der Hem, G K, Kallenberg, C G
• Format: Journal Article
• Language: English
• Published: England 22.09.1990
• Subjects: Adult; Aged; Antibodies, Anti-Idiotypic - analysis; Autoantibodies - analysis; Cyclophosphamide - administration & dosage; Cyclophosphamide - therapeutic use; Cytoplasmic Granules - immunology; Drug Evaluation; Female; Granulomatosis with Polyangiitis - drug therapy; Granulomatosis with Polyangiitis - immunology; Granulomatosis with Polyangiitis - prevention & control; Humans; Male; Middle Aged; Neutrophils - immunology; Prednisolone - administration & dosage; Prednisolone - therapeutic use; Prospective Studies; Randomized Controlled Trials as Topic; Recurrence; Time Factors
• ISSN: 0140-6736
• DOI: 10.1016/0140-6736(90)92205-V

58 patients with biopsy-proven Wegener's granulomatosis (WG) were prospectively screened for clinical evidence of the disease 3-monthly, with antineutrophil cytoplasmic antibody (ANCA) measurements every month. Over 24 months, ANCA rose in 20 patients, 9 of whom were randomly assigned to receive combined 9 and 3 month courses of cyclophosphamide and prednisolone, respectively, at the time of ANCA rise; and 11 patients who were untreated except if there was a clinical relapse. 6 of 11 untreated patients relapsed within 3 months of ANCA rise. 3 of the remaining 5 patients relapsed after 3 months. There were no early or late relapses in patients randomised to treatment. Patients receiving no treatment at the time of ANCA rise took more cyclophosphamide and prednisolone than patients who were treated. Side-effects did not significantly differ between the two groups.