Association between longitudinal ANCA patterns and risk of
clinical relapse
The proportion of patients who developed a clinical relapse was similar
in patients with recurrent or persistent ANCA patterns (34/39; 87.2%
vs. 15/21; 71.4%; p=0.13). These relapse rates were much higher than
those observed in patients with monophasic or remitting ANCA patterns
(6/29; 23.1% and 4/13; 30.8% respectively)(Table 2). Because of these
similarities, in some analyses the four subsets were joined into two
groups, the recurrent/persistent (R/P) pattern and the
monophasic/remitting (M/R) pattern (Fig 1).
In the univariate analysis, other variables associated with an increased
risk of clinical relapse were the diagnosis of GPA, the anti-PR3
specificity, the presence of arthritis, ENT or ocular involvement, and
having received treatment with azathioprine, methotrexate or rituximab.
Clinical features such as renal failure were associated with a lower
risk of clinical relapse (Table 3).
In the multivariate Cox regression analysis, the recurrent or persistent
ANCA patterns together with the presence of arthritis or ocular
involvement, the absence of fever or having received rituximab treatment
were independently associated with a higher risk of clinical relapse.
Neither the clinical diagnosis, nor the antigenic specificity were
associated with an increased risk of clinical relapse (Table 4).