We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Plasma exchange therapy in ANCA-associated vasculitis: A single-center retrospective cohort study.
- Authors
Özgüler, Yeşim; Ak, Tümay; Esatoğlu, Sinem Nihal; Elverdi, Tuğrul; Eşkazan, Ahmet Emre; Uğurlu, Serdal; Hatemi, Gülen; Seyahi, Emire; Melikoğlu, Melike; Fresko, İzzet; Ar, Muhlis Cem; Hamuryudan, Vedat
- Abstract
Objective: Meta-analysis of randomized controlled trials showed that plasma exchange (PLEX) has no significant effect on mortality and reduces the 12-month risk of end-stage kidney disease at the cost of increasing the risk of serious infections in patients with ANCAassociated vasculitis (AAV). Methods: We retrospectively reviewed patient charts who underwent PLEX therapy between October 2013 and March 2022 in our apheresis unit. Patients who were under 18 and underwent PLEX therapy for non-rheumatic and rheumatic diseases other than AAV were excluded. We collected all information regarding the primary indication of PLEX therapy, procedure details, concomitant immunosuppressives, overall survival, outcomes of organ involvement, and complications related to PLEX therapy. Results: Twenty-eight patients (Male/Female: 18/10) with AAV were evaluated. Diffuse alveolar hemorrhage (DAH) was the primary indication for PLEX therapy in 6 (21%) patients [myeloperoxidase (MPO)/proteinase-3 (PR-3): 1/5], kidney involvement and/or DAH in 22 (79%) (MPO/PR-3: 10/11). Overall, there were 16 (57%) severe/opportunistic infections and 5 (18%) deaths within the first three months. One (4%) severe infection (COVID-19) and 3 (11%) deaths were observed between 3 and 12 months. Overall, 10 (45%) patients were hemodialysis-dependent at month three, and there were no additional dialysis-dependent patients in the 12th month. Conclusion: most infections and deaths occurred within the first three months of PLEX therapy. The renal outcome was poor in patients with high-risk baseline creatinine levels (=5.8 mg/dL). Despite this, having no new dialysis-dependent patients between 3 and 12 months suggests that PLEX still can be an option as an adjunct therapy, especially in some subgroups of AAV patients in daily practice.
- Subjects
PLASMA exchange (Therapeutics); VASCULITIS; HEMORRHAGE; MYELOPEROXIDASE; PROTEINASES
- Publication
Journal of Turkish Society for Rheumatology, 2022, Vol 14, Issue 3, p131
- ISSN
2651-2653
- Publication type
Article
- DOI
10.4274/raed.galenos.2022.09719