Plasma exchange and glucocorticoids to delay death or end-stage renal disease in anti-neutrophil cytoplasm antibody-associated vasculitis: PEXIVAS non-inferiority factorial RCT

• Published in: Health Technology Assessment Vol. 26; no. 38; pp. 1 - 60
• Main Authors: Jayne, David, Walsh, Michael, Merkel, Peter A, Peh, Chen Au, Szpirt, Wladimir, Puéchal, Xavier, Fujimoto, Shouichi, Hawley, Carmel, Khalidi, Nader, Jones, Rachel, Flossmann, Oliver, Wald, Ron, Girard, Louis, Levin, Adeera, Gregorini, Gina, Harper, Lorraine, Clark, William, Pagnoux, Christian, Specks, Ulrich, Smyth, Lucy, Ito-Ihara, Toshiko, de Zoysa, Janak, Brezina, Biljana, Mazzetti, Andrea, McAlear, Carol A, Reidlinger, Donna, Mehta, Samir, Ives, Natalie, Brettell, Elizabeth A, Jarrett, Hugh, Wheatley, Keith, Broadhurst, Elizabeth, Casian, Alina, Pusey, Charles D
• Format: Journal Article
• Language: English
• Published: England National Institute for Health and Care Research 01.09.2022; NIHR Journals Library
• Subjects: anca; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - drug therapy; Autoantibodies; Autoantibodies - therapeutic use; Cost-Benefit Analysis; Cyclophosphamide; Cyclophosphamide - therapeutic use; Cytoplasm; glomerulonephritis; glucocorticoids; Glucocorticoids - therapeutic use; Humans; Kidney Failure, Chronic; Kidney Failure, Chronic - therapy; lung haemorrhage; Medical technology; Myeloblastin; Peroxidase; Peroxidase - therapeutic use; plasma exchange; Prednisolone; Prednisolone - therapeutic use; R855-855.5; randomised; Rituximab; Rituximab - therapeutic use; vasculitis; GLOMERULONEPHRITIS; PLASMA EXCHANGE; GLUCOCORTICOIDS; RANDOMISED; ANCA; VASCULITIS; LUNG HAEMORRHAGE

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 toxici...