Yumura Wako, Kobayashi Shigeto, Suka Machi, Hayashi Taichi, Ito Satoshi, Nagafuchi Hiroko, Yamada Hidehiro, Ozaki Shoichi
Department of Nephrology, Internal Medicine, International University of Health and Warfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi, 329l-2763, Japan,
Mod Rheumatol. 2013 May 28. doi: 10.1007/s10165-013-0889-9.
In the study cohort enrolled in a prospective open-label, multicenter trial conducted by the Japanese Study Group for MPO-ANCA-associated vasculitis (JMAAV), we conducted this sub-analysis to establish the validity of the Birminghan vasculitis activity score (BVAS) for Japanese patients with MPO-ANCA-associated vasculitis. METHODS: We recorded the BVAS at the time of diagnosis, at 6 weeks after the diagnosis, and at 3, 6, 9, 12, 15 and 18 months after the diagnosis in this study. RESULTS: The most frequently involved organs in the patients were the lungs, kidneys and the nervous system. The kidney (BVAS; new/worse 69.2 %, persistent 40.4 %), general (BVAS; new/worse 67.3 %, persistent 53.8 %), chest (BVAS; new/worse 36.5 %, persistent 46.2 %) and nervous system (BVAS; new/worse 38.5 %, persistent 25.0 %) were the organ systems most frequently involved by the disease at the baseline. The BVAS for new/worse disease decreased immediately after induction therapy, while improvement of the BVAS for persistent disease after therapy differed among the organ systems. CONCLUSIONS: BVAS was demonstrated to be a valuable guide for selection of the optimal treatment. Thus, BVAS was also found to be a useful tool in Japanese patients for the assessment of disease activity and degree of organ damage in patients with MPO-ANCA-associated vasculitis.
在由日本MPO - ANCA相关性血管炎研究组(JMAAV)进行的一项前瞻性开放标签多中心试验纳入的研究队列中,我们开展了这项亚分析,以确立伯明翰血管炎活动评分(BVAS)对日本MPO - ANCA相关性血管炎患者的有效性。方法:在本研究中,我们记录了诊断时、诊断后6周以及诊断后3、6、9、12、15和18个月时的BVAS。结果:患者中最常受累的器官是肺、肾和神经系统。肾脏(BVAS;新发/加重69.2%,持续40.4%)、全身(BVAS;新发/加重67.3%,持续53.8%)、胸部(BVAS;新发/加重36.5%,持续46.2%)和神经系统(BVAS;新发/加重38.5%,持续25.0%)是基线时疾病最常累及的器官系统。诱导治疗后新发/加重疾病的BVAS立即下降,而治疗后持续疾病的BVAS改善在各器官系统中有所不同。结论:BVAS被证明是选择最佳治疗的有价值指南。因此,BVAS也是日本MPO - ANCA相关性血管炎患者评估疾病活动度和器官损伤程度的有用工具。