Article Text

other Versions

PDF
Anti-myeloperoxidase antibodies are a useful marker of disease activity in ANCA-associated vasculitides
  1. Benjamin Terrier (bterrier{at}noos.fr)
  1. Groupe Hospitalier Pitié-Salpétrière, France
    1. David Saadoun
    1. Groupe Hospitalier Pitié-Salpétrière, France
      1. Damien Sène
      1. Groupe Hospitalier Pitié-Salpétrière, France
        1. Pascale Ghillani-Dalbin
        1. Groupe Hospitalier Pitié-Salpétrière, France
          1. Zahir Amoura
          1. Groupe Hospitalier Pitié-Salpétrière, France
            1. Gilbert Deray
            1. Groupe Hospitalier Pitié-Salpétrière, France
              1. Bruno Fautrel
              1. Groupe Hospitalier Pitié-Salpétrière, France
                1. Jean-Charles Piette
                1. Groupe Hospitalier Pitié-Salpétrière, France
                  1. Patrice Cacoub (patrice.cacoub{at}psl.aphp.fr)
                  1. Groupe Hospitalier Pitié-Salpétrière, France

                    Abstract

                    Objective: To evaluate the relevance of monitoring anti-myeloperoxidase antibody (anti-MPO Ab) levels in the management of anti-MPO-associated vasculitides.

                    Methods: Thirty-eight patients with anti-MPO-associated vasculitides were included: microscopic polyangiitis (n=18), Wegener’s granulomatosis (n=15) and Churg-Strauss syndrome (n=5). Baseline characteristics and outcomes were recorded. Serial measurements of anti-MPO Ab levels were performed (ELISA, positive≥20 IU/mL).

                    Results: All patients achieved vasculitis remission after a mean time of 2.0±0.9 months, with a significant decrease in the mean anti-MPO Ab level at remission (478±598 vs. 41±100 IU/mL; P<0.001). Twenty-eight (74%) patients became anti-MPO Ab negative. After a mean follow-up of 54±38 months, 12 cases of clinical relapse occurred in 11/38 (29%) patients. Relapses were associated with an increase in anti-MPO Ab levels in 10/11 (91%) patients (34±88 vs. 199±314 IU/mL; P=0.002). The reappearance of anti-MPO Abs after achieving negative levels was significantly associated with relapse (OR 117; 95% CI 9.4-1450; P<0.001). Anti-MPO Abs showed a positive predictive value of 90% and a negative predictive value of 94% for relapse of vasculitis. Up to 60% of cases of relapse occurred less than 12 months after the reappearance of anti-MPO Abs. Relapse-free survival was significantly worse for patients who exhibited a reappearance of anti-MPO Abs than in those with persistent negative anti-MPO Abs (P<0.001). Anti-MPO Abs serum level was strongly correlated with the BVAS and the DEI (r = +0.49 ; P = 0.002).

                    Conclusion: Through monitoring, anti-MPO Abs are a useful marker of disease activity and a good predictor of relapse in anti-MPO-associated vasculitides.

                    Statistics from Altmetric.com

                    Request permissions

                    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.