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Cited by 893

The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.

Plasma Exchange and Glucocorticoids in Severe ANCA-Associated Vasculitis

Open access
Walsh, Michael, Merkel, Peter A., Peh, Chen-Au, Szpirt, Wladimir M., Puéchal, Xavier, Fujimoto, Shouichi, Hawley, Carmel M., Khalidi, Nader, Floßmann, Oliver, Wald, Ron, Girard, Louis P., Levin, Adeera, Gregorini, Gina, Harper, Lorraine, Clark, William F., Pagnoux, Christian, Specks, Ulrich, Smyth, Lucy, Tesar, Vladimir, Ito-Ihara, Toshiko, de Zoysa, Janak Rashme, Szczeklik, Wojciech, Flores-Suárez, Luis Felipe, Carette, Simon, Guillevin, Loïc, Pusey, Charles D., Casian, Alina L., Brezina, Biljana, Mazzetti, Andrea, McAlear, Carol A., Broadhurst, Elizabeth, Reidlinger, Donna, Mehta, Samir, Ives, Natalie, Jayne, David R.W.·2020·New England Journal of Medicine

Abstract

BACKGROUND: More effective and safer treatments are needed for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. METHODS: of body-surface area or diffuse pulmonary hemorrhage). Patients were randomly assigned to undergo plasma exchange (seven plasma exchanges within 14 days after randomization) or no plasma exchange (control group). Patients were also randomly assigned to follow either a standard-dose regimen or a reduced-dose regimen of oral glucocorticoids. Patients were followed for up to 7 years for the primary composite outcome of death from any cause or end-stage kidney disease (ESKD). RESULTS: Death from any cause or ESKD occurred in 100 of 352 patients (28.4%) in the plasma-exchange group and in 109 of 352 patients (31.0%) in the control group (hazard ratio, 0.86; 95% confidence interval [CI], 0.65 to 1.13; P = 0.27). The results were similar in subgroup analyses and in analyses of secondary outcomes. We also assessed the noninferiority of a reduced-dose regimen of glucocorticoids to a standard-dose regimen, using a noninferiority margin of 11 percentage points. Death from any cause or ESKD occurred in 92 of 330 patients (27.9%) in the reduced-dose group and in 83 of 325 patients (25.5%) in the standard-dose group (absolute risk difference, 2.3 percentage points; 90% CI, -3.4 to 8.0), which met the criterion for noninferiority. Serious infections at 1 year were less common in the reduced-dose group than in the standard-dose group (incidence rate ratio, 0.69; 95% CI, 0.52 to 0.93), but other secondary outcomes were similar in the two groups. CONCLUSIONS: Among patients with severe ANCA-associated vasculitis, the use of plasma exchange did not reduce the incidence of death or ESKD. A reduced-dose regimen of glucocorticoids was noninferior to a standard-dose regimen with respect to death or ESKD. (Funded by the U.K. National Institute for Health Research and others; PEXIVAS Current Controlled Trials number, ISRCTN07757494; ClinicalTrials.gov number, NCT00987389.).

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Metadata

Authors
Walsh, M., Merkel, P. A., Peh, C.-A., Szpirt, W. M., Puéchal, X., Fujimoto, S., Hawley, C. M., Khalidi, N., Floßmann, O., Wald, R., Girard, L. P., Levin, A., Gregorini, G., Harper, L., Clark, W. F., Pagnoux, C., Specks, U., Smyth, L., Tesar, V., Ito-Ihara, T., de Zoysa, J. R., Szczeklik, W., Flores-Suárez, L. F., Carette, S., Guillevin, L., Pusey, C. D., Casian, A. L., Brezina, B., Mazzetti, A., McAlear, C. A., Broadhurst, E., Reidlinger, D., Mehta, S., Ives, N., & Jayne, D. R. W.
Venue
New England Journal of Medicine
Published
2020-02-13
Volume
382
Issue
7
Pages
622-631
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W3004897282
Cited by
893
References
34
FWCI
62.92
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Plasma Exchange and Glucocorticoids in Severe ANCA-Associated Vasculitis. https://app.cochat.ai/papers/10.1056/nejmoa1803537
The paper
Walsh, M., Merkel, P. A., Peh, C.-A., Szpirt, W. M., Puéchal, X., Fujimoto, S., Hawley, C. M., Khalidi, N., Floßmann, O., Wald, R., Girard, L. P., Levin, A., Gregorini, G., Harper, L., Clark, W. F., Pagnoux, C., Specks, U., Smyth, L., Tesar, V., . . . Jayne, D. R. W. (2020). Plasma Exchange and Glucocorticoids in Severe ANCA-Associated Vasculitis. New England Journal of Medicine. https://doi.org/10.1056/nejmoa1803537

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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.