ANCA Levels and Disease Activity in Wegener Granulomatosis

Increased ANCA levels in patients in sustained remission should not prompt presumptive therapy without clinical evidence of disease activity.

Accurately predicting disease activity and relapse is the greatest challenge in the management of Wegener granulomatosis. Although the diagnostic value of antineutrophil cytoplasmic antibody (ANCA) levels is well established, the role of serial ANCA measurement to guide therapy remains controversial.

In this prospective, multicenter, observational cohort study of 156 patients, the authors sought answers to these questions:

Are pro-proteinase-3 (PR3)-ANCA levels a better measure of disease activity than levels of mature PR3-ANCA?
Are decreases in either level associated with a shorter time to remission?
Are increases followed by relapse?

Patients were treated with etanercept or placebo plus standard therapy (either cyclophosphamide or methotrexat…

Reviewing Author

Deborah M. DeMarco, MD

ANCA Levels and Disease Activity in Wegener Granulomatosis

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Reviewing Author