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From: Antiproteinase 3 Antineutrophil Cytoplasmic Antibodies and Disease Activity in Wegener Granulomatosis Ann Intern Med. 2007;147(9):611-619. doi:10.7326/0003-4819-147-9-200711060-00005.

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Presentation on theme: "From: Antiproteinase 3 Antineutrophil Cytoplasmic Antibodies and Disease Activity in Wegener Granulomatosis Ann Intern Med. 2007;147(9):611-619. doi:10.7326/0003-4819-147-9-200711060-00005."— Presentation transcript:

1 From: Antiproteinase 3 Antineutrophil Cytoplasmic Antibodies and Disease Activity in Wegener Granulomatosis Ann Intern Med. 2007;147(9): doi: / Figure Legend: The fourth clinical visit was the first point at which a patient could meet the study definition of sustained remission (SR) (a Birmingham Vasculitis Activity Score for Wegener granulomatosis [BVAS/WG] of 0 for 6 months) and was the first time we looked for an increase in proteinase 3 (PR3) antineutrophil cytoplasmic antibody (ANCA) levels. We compared the net absorbance of PR3-ANCA at this visit with that of the previous 2 visits or the previous 6 months (curved lines). The same comparison was done at every subsequent visit. Date of download: 12/31/2017 Copyright © American College of Physicians. All rights reserved.

2 From: Antiproteinase 3 Antineutrophil Cytoplasmic Antibodies and Disease Activity in Wegener Granulomatosis Ann Intern Med. 2007;147(9): doi: / Figure Legend: Arrowheads indicate a decrease in proteinase 3 (PR3)–ANCA levels during the initial 6 months of follow-up, and circles indicate an increase in PR3-ANCA level. The horizontal line at 0.1 represents the cutoff value of the tests; results above or equal to this value are considered positive. A. Increase in PR3-ANCA levels followed by relapse (R). The increase in PR3-ANCA levels began before the patient met the definition for sustained remission (SR). B. Increase in PR3-ANCA levels with no subsequent relapse in the following 2 years. C. Relapse without a preceding increase in mature- or pro-PR3–ANCA levels. D. Unchanging PR3-ANCA levels during follow-up after sustained remission. This patient achieved and remained in sustained remission. E. Continued disease activity with a decrease in PR3-ANCA levels, although with improvement as PR3-ANCA levels decreased. F. Continuously negative PR3-ANCA levels without achieving sustained remission. BVAS/WG = Birmingham Vasculitis Activity Score for Wegener granulomatosis. Date of download: 12/31/2017 Copyright © American College of Physicians. All rights reserved.

3 From: Antiproteinase 3 Antineutrophil Cytoplasmic Antibodies and Disease Activity in Wegener Granulomatosis Ann Intern Med. 2007;147(9): doi: / Figure Legend: Mature- and pro-PR3–ANCA levels were statistically significantly higher at baseline (median Birmingham Vasculitis Activity Score for Wegener granulomatosis [BVAS/WG], 6.5) than at sustained remission (BVAS/WG, 0). The median level decreased from 1.46 to 0.92 for mature-PR3 ANCA and from 0.88 to 0.40 for pro-PR3–ANCA. In this analysis, only the 101 patients who were positive for mature-PR3–ANCA at baseline and had sustained remission were included. The middle horizontal lines represent the median, and the bars represent the interquartile range. Date of download: 12/31/2017 Copyright © American College of Physicians. All rights reserved.

4 From: Antiproteinase 3 Antineutrophil Cytoplasmic Antibodies and Disease Activity in Wegener Granulomatosis Ann Intern Med. 2007;147(9): doi: / Figure Legend: Top. Mature proteinase 3 (PR3) antineutrophil cytoplasmic antibody (ANCA) levels and remission. Bottom. Pro-PR3–ANCA levels and remission. Data are Kaplan–Meier estimates of time to sustained remission in the 134 patients who were positive for mature-PR3–ANCA at baseline. Time 0 corresponds to the date of enrollment in the study. Sustained remission was defined as a Birmingham Vasculitis Activity Score (BVAS/WG) of 0 for a minimum of 6 months. Adjusting variables were age, sex, disease severity (severe vs. limited), treatment group (etanercept vs. placebo), disease duration, baseline BVAS/WG, and clinical center. Date of download: 12/31/2017 Copyright © American College of Physicians. All rights reserved.

5 From: Antiproteinase 3 Antineutrophil Cytoplasmic Antibodies and Disease Activity in Wegener Granulomatosis Ann Intern Med. 2007;147(9): doi: / Figure Legend: *The increase in PR3-ANCA levels took place at or after the patient achieved sustained remission. †Fourteen of these patients had gaps in PR3-ANCA measurements longer than 6 months; of those, 4 had relapse. ‡Seventeen of these patients had gaps in PR3-ANCA measurements longer than 6 months; of those, 4 had relapse. §Seven of these patients had gaps in PR3-ANCA measurements longer than 6 months; of those, 1 had relapse. Date of download: 12/31/2017 Copyright © American College of Physicians. All rights reserved.

6 From: Antiproteinase 3 Antineutrophil Cytoplasmic Antibodies and Disease Activity in Wegener Granulomatosis Ann Intern Med. 2007;147(9): doi: / Figure Legend: The vertical dotted line marks the time of sustained remission. The x-axis corresponds to the 6 months preceding and the time following sustained remission. In patients with relapse (top), the mature-PR3–ANCA levels for each patient were plotted to the time of relapse. In patients without relapse (bottom), the mature-PR3–ANCA levels for each patient were plotted to the end of the trial. Date of download: 12/31/2017 Copyright © American College of Physicians. All rights reserved.


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