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Association of Serum Calprotectin (S100A8/A9) Level With Disease Relapse in Proteinase 3-Antineutrophil Cytoplasmic Antibody-Associated Vasculitis.

Authors :
Pepper RJ
Draibe JB
Caplin B
Fervenza FC
Hoffman GS
Kallenberg CG
Langford CA
Monach PA
Seo P
Spiera R
William St Clair E
Tchao NK
Stone JH
Specks U
Merkel PA
Salama AD
Source :
Arthritis & rheumatology (Hoboken, N.J.) [Arthritis Rheumatol] 2017 Jan; Vol. 69 (1), pp. 185-193.
Publication Year :
2017

Abstract

Objective: S100A8/A9 (calprotectin) has shown promise as a biomarker for predicting relapse in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). This study was undertaken to investigate serum S100A8/A9 level as a biomarker for predicting future relapse in a large cohort of patients with severe AAV.<br />Methods: Serum levels of S100A8/A9 were measured at baseline and months 1, 2, and 6 following treatment initiation in 144 patients in the Rituximab in ANCA-Associated Vasculitis trial (cyclophosphamide/azathioprine versus rituximab [RTX] for induction of remission) in whom complete remission was attained.<br />Results: Patients were divided into 4 groups: proteinase 3 (PR3)-ANCA with relapse (n = 37), PR3-ANCA without relapse (n = 56), myeloperoxidase (MPO)-ANCA with relapse (n = 6), and MPO-ANCA without relapse (n = 45). Serum S100A8/A9 level decreased in all groups during the first 6 months of treatment. The percentage reduction from baseline to month 2 was significantly different between patients who experienced a relapse and those who did not in the PR3-ANCA group (P = 0.046). A significantly higher risk of relapse was associated with an increase in S100A8/A9 level between baseline and month 2 (P = 0.0043) and baseline and month 6 (P = 0.0029). Subgroup analysis demonstrated that patients treated with RTX who had increased levels of S100A8/A9 were at greatest risk of future relapse (P = 0.028).<br />Conclusion: An increase in serum S100A8/A9 level by month 2 or 6 compared to baseline identifies a subgroup of PR3-ANCA patients treated with RTX who are at higher risk of relapse by 18 months. Since RTX is increasingly used for remission induction in PR3-ANCA-positive patients experiencing a relapse, S100A8/A9 level may assist in identifying those patients requiring more intensive or prolonged treatment.<br /> (© 2016, American College of Rheumatology.)

Details

Language :
English
ISSN :
2326-5205
Volume :
69
Issue :
1
Database :
MEDLINE
Journal :
Arthritis & rheumatology (Hoboken, N.J.)
Publication Type :
Academic Journal
Accession number :
27428710
Full Text :
https://doi.org/10.1002/art.39814