Aferesi nelle vasculiti.

Translated title of the contribution: [Apheresis in the treatment of vasculitis].

Danio Somenzi, Mattia Corradini, Sonia Pasquali

Research output: Contribution to journalArticle

Abstract

ANCA-associated vasculitides are a group of inflammatory diseases affecting medium and small vessels with a redundant and hence complex pathogenetic mechanism. Since their first identification, their dismal prognosis has forced researchers to find effective therapies. The prognosis has changed since the advent of immunomodulatory drugs like steroids, cyclophosphamide, azathioprine, mycophenolate mofetil and, more recently, biological drugs. Plasmapheresis in association with immune suppressant drugs has shown beneficial effects in some clinical trials, mostly in dialysis-dependent patients. Apheresis should remove, in a nonselective manner, pathogenetic antibodies like ANCA but also immune complexes, cytokines and inflammatory mediators. A recent meta-analysis took into account 28 randomized clinical trials studying therapeutic interventions in adult vasculitis with renal involvement, six of them scheduling plasmapheresis as adjunctive therapy to immune suppressant drugs. This association significantly reduced the need for dialysis at three (1 trial: RR 0.45, 95% CI 0.24-0.84) and twelve (5 trials: RR 0.47, 95% CI 0.3-0.75) months but not the mortality at one year. We can conclude that plasmapheresis is an effective treatment option for vasculitides with severe renal failure. It can also be considered in case of ineffectiveness of or contraindications to standard treatment.

Original languageItalian
JournalGiornale italiano di nefrologia : organo ufficiale della Società italiana di nefrologia
Volume29 Suppl 54
Publication statusPublished - Jan 2012

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Blood Component Removal
Vasculitis
Plasmapheresis
Pharmaceutical Preparations
Dialysis
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Mycophenolic Acid
Therapeutics
Antineutrophil Cytoplasmic Antibodies
Azathioprine
Antigen-Antibody Complex
Cyclophosphamide
Renal Insufficiency
Meta-Analysis
Randomized Controlled Trials
Steroids
Research Personnel
Clinical Trials
Cytokines
Kidney

ASJC Scopus subject areas

  • Nephrology

Cite this

Aferesi nelle vasculiti. / Somenzi, Danio; Corradini, Mattia; Pasquali, Sonia.

In: Giornale italiano di nefrologia : organo ufficiale della Società italiana di nefrologia, Vol. 29 Suppl 54, 01.2012.

Research output: Contribution to journalArticle

Somenzi, Danio ; Corradini, Mattia ; Pasquali, Sonia. / Aferesi nelle vasculiti. In: Giornale italiano di nefrologia : organo ufficiale della Società italiana di nefrologia. 2012 ; Vol. 29 Suppl 54.
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