Risk Factors for Cytomegalovirus Reactivation during the Treatment of ANCA-Associated Vasculitis: A retrospective cohort study of the J-CANVAS study.

IF 1.8 4区医学 Q3 RHEUMATOLOGY

Modern Rheumatology Pub Date : 2025-01-31 DOI:10.1093/mr/roaf008

Kazutaka Kawamori, Nao Oguro, Kunika Shimizu, Takashi Kida, Satoshi Omura, Daiki Nakagomi, Yoshiyuki Abe, Masatoshi Kadoya, Naoho Takizawa, Atsushi Nomura, Yuji Kukida, Naoya Kondo, Yasuhiko Yamano, Takuya Yanagida, Koji Endo, Shintaro Hirata, Kiyoshi Matsui, Tohru Takeuchi, Kunihiro Ichinose, Masaru Kato, Ryo Yanai, Yusuke Matsuo, Yasuhiro Shimojima, Ryo Nishioka, Ryota Okazaki, Tomoaki Takata, Takafumi Ito, Mayuko Moriyama, Ayuko Takatani, Yoshia Miyawaki, Toshiko Ito-Ihara, Takashi Kawaguchi, Yutaka Kawahito, Nobuyuki Yajima

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引用次数: 0

Abstract

Objectives: Cytomegalovirus (CMV) reactivation during immunosuppressive therapy poses a risk of severe infections. This study aimed to investigate the risk factors of CMV reactivation in patients with microscopic polyangiitis and granulomatosis with polyangiitis using a nationwide cohort in Japan.

Methods: This retrospective cohort study used data from the Japan Collaborative Registry of anti-neutrophil cytoplasmic antibody-associated vasculitis. The outcome was as CMV reactivation up to 48 weeks after treatment initiation. We explored the risk factors for CMV reactivation by comparing the two groups.

Results: Of the 454 patients, CMV reactivation occurred in 89 (19.6%). The univariate analysis showed that patients with CMV reactivation were older (p<0.001), had higher Birmingham Vasculitis Activity Scores (BVAS) (p=0.004) and BVAS renal scores (p<0.001), and had received glucocorticoid pulse (p=0.004). The logistic regression analysis showed that hypoalbuminemia (odds ratio [OR]: 0.55, 95% confidence interval [CI]: 0.31-0.98), and low serum IgG (OR: 0.94, 95% CI: 0.89-1.00) were risk factors for CMV reactivation.

Conclusions: Hypoalbuminemia and low serum IgG levels were risk factors for CMV reactivation. It is necessary to accurately identify high-risk patients and closely monitor their condition.

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来源期刊

Modern Rheumatology RHEUMATOLOGY-

CiteScore

4.90

自引率

9.10%

发文量

146

审稿时长

1.5 months

期刊介绍： Modern Rheumatology publishes original papers in English on research pertinent to rheumatology and associated areas such as pathology, physiology, clinical immunology, microbiology, biochemistry, experimental animal models, pharmacology, and orthopedic surgery. Occasional reviews of topics which may be of wide interest to the readership will be accepted. In addition, concise papers of special scientific importance that represent definitive and original studies will be considered. Modern Rheumatology is currently indexed in Science Citation Index Expanded (SciSearch), Journal Citation Reports/Science Edition, PubMed/Medline, SCOPUS, EMBASE, Chemical Abstracts Service (CAS), Google Scholar, EBSCO, CSA, Academic OneFile, Current Abstracts, Elsevier Biobase, Gale, Health Reference Center Academic, OCLC, SCImago, Summon by Serial Solutions