Comparison of the epidemiology of anti-neutrophil cytoplasmic antibody-associated vasculitis between Japan and the UK
Shouichi Fujimoto,Richard A. Watts,Shigeto Kobayashi,Kazuo Suzuki,David Jayne,David G. I. Scott,Hiroshi Hashimoto,Hiroyuki Nunoi +7 more
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TLDR
There was no major difference in AAV incidence between Japan and the U.K., but this prospective study found MPA and MPO-ANCA to be more common in Japan and granulomatosis with polyangiitis and PR3-AN CA to beMore common in theU.K, in line with earlier reports.Abstract:
Objectives. The epidemiological manifestations of ANCA-associated vasculitis (AAV) differ geographically. However, there have been no prospective studies comparing the incidence of AAV between Japan and Europe over the same time period using the same case definitions. Methods. The incidence of AAV was determined by a population-based method in Miyazaki prefecture, Japan, and Norfolk, UK, between 2005 and 2009. Patients with AAV were defined and classified according to the European Medicines Agency (EMEA) algorithm. Results. The number of incident cases of AAV in Japan and the UK were 86 and 50, respectively, and the average annual incidence over the 5-year period was 22.6/million (95% CI 19.1, 26.2) and 21.8/million (95% CI 12.6, 30.9) in Japan and the UK, respectively. The average age was higher in patients in Japan than in patients in the UK [mean (median), 69.7 (72) vs 60.5 (61) years]. Microscopic polyangiitis (MPA) was the predominant subtype in Japan (83%), while granulomatosis with polyangiitis (Wegener’s) was more frequent in the UK (66%). As for the pattern of ANCA positivity, >80% of Japanese patients were pANCA/ MPO positive, whereas two-thirds of UK patients were cANCA/PR3 positive. Renal involvement in MPA was very common in both countries, but was much less common in granulomatosis with polyangiitis in Japan compared with the UK. Conclusion. There was no major difference in AAV incidence between Japan and the UK, but this prospective study found MPA and MPO-ANCA to be more common in Japan and granulomatosis with polyangiitis and PR3-ANCA to be more common in the UK, in line with earlier reports.read more
Citations
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Journal ArticleDOI
ANCA-associated vasculitis.
A. Richard Kitching,Hans-Joachim Anders,Neil Basu,Elisabeth Brouwer,Jennifer Gordon,David Jayne,Joyce Kullman,Paul A. Lyons,Peter A. Merkel,Caroline O. S. Savage,Ulrich Specks,Renate Kain +11 more
TL;DR: The classification of AAVs and the pathogenetic mechanisms, diagnosis and treatment of these debilitating conditions are discussed and a need for targeted therapies with fewer adverse effects is needed.
Journal ArticleDOI
Pathogenesis and therapeutic interventions for ANCA-associated vasculitis
TL;DR: Advances in the understanding of anti-neutrophil cytoplasmic antibody-associated vasculitis are described and promising new treatments that target B cells, T cells and cytokines are generated; potential novel approaches targeting additional cells or molecules are also discussed.
Journal ArticleDOI
ANCA-associated vasculitis - clinical utility of using ANCA specificity to classify patients.
TL;DR: Accumulating evidence suggests that ANCA specificity could be better than clinical diagnosis for defining homogeneous groups of patients, as PR3-ANCA and MPO-AnCA are associated with different genetic backgrounds and epidemiology.
Journal ArticleDOI
Pathogenesis of Antineutrophil Cytoplasmic Autoantibody–Associated Small-Vessel Vasculitis
TL;DR: Clinical, in vitro, and experimental animal observations indicate that antineutrophil cytoplasmic autoantibodies (ANCA) are pathogenic and cause granulomatous inflammation.
Journal ArticleDOI
Classification, epidemiology and clinical subgrouping of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis
Richard A. Watts,Alfred Mahr,Aladdin J Mohammad,Paul A. Gatenby,Neil Basu,Luis Felipe Flores-Suárez +5 more
TL;DR: The vasculitides are rare, and therefore, a large population is required to determine the incidence and prevalence, and this poses questions of feasibility, whereas a smaller population requires a much longer time frame to collect the necessary cases, which may not be feasible.
References
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Gary S. Hoffman,Gail S. Kerr,Randi Y. Leavitt,Claire W. Hallahan,Robert S. Lebovics,William D. Travis,Menachem Rottem,Anthony S. Fauci +7 more
TL;DR: The course of Wegener granulomatosis has been dramatically improved by daily treatment with cyclophosphamide and glucocorticoids, and has led to increasing concerns about toxicity resulting from prolonged cycloph phosphamide therapy and has encouraged investigation of other therapeutic regimens.
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Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies
Richard A. Watts,SE Lane,Thomas Hanslik,Thomas H. Hauser,Bernhard Hellmich,Wenche Koldingsnes,Alfred Mahr,Mårten Segelmark,Jan Willem Cohen-Tervaert,David Scott +9 more
TL;DR: A stepwise algorithm developed by consensus between a group of doctors interested in the epidemiology of vasculitis successfully categorises patients into a single classification of patients with Wegener’s granulomatosis, microscopic polyangiitis, Churg–Strauss syndrome and PAN into single clinically relevant categories.
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Sreeram V. Ramagopalan,Andreas Heger,Antonio J. Berlanga,Narelle J. Maugeri,Matthew R. Lincoln,Amy M Burrell,Lahiru Handunnetthi,Adam E. Handel,Giulio Disanto,S M Orton,Corey T. Watson,Julia M. Morahan,Gavin Giovannoni,Chris P. Ponting,George C. Ebers,Julian C. Knight +15 more
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