イハラ　トシコ   Toshiko Ito-Ihara   猪原　登志子    所属   川崎医科大学  医学部 応用医学　先端医療開発学    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Diabetes mellitus and cardiac disease as key predictors of rituximab-induced acute thrombocytopenia in ANCA-associated vasculitis.
掲載誌名	正式名：Rheumatology (Oxford, England) 略　 称：Rheumatology (Oxford) ISSNコード：14620332/14620324
掲載区分	国外
巻・号・頁	65(1),pp.529
著者・共著者	Satoshi Akao, Masaru Shimizu, Kazushi Maruo, Hiromitsu Asashima, Yuya Kondo, Ayako Ohyama, Saori Abe, Ayako Kitada, Haruka Miki, Hiroto Tsuboi, Satoshi Omura, Daiki Nakagomi, Yoshiyuki Abe, Makoto Wada, Naoho Takizawa, Atsushi Nomura, Yuji Kukida, Naoya Kondo, Hirosuke Takagi, Koji Endo, Shintaro Hirata, Naoto Azuma, Tohru Takeuchi, Shoichi Fukui, Kazuro Kamada, Ryo Yanai, Yusuke Matsuo, Yasuhiro Shimojima, Ryo Nishioka, Ryota Okazaki, Tomoaki Takata, Mayuko Moriyama, Ayuko Takatani, Yoshia Miyawaki, Tsuyoshi Shirai, Hiroaki Dobashi, Takafumi Ito, Toshihiko Takada, Yutaka Kawahito, Toshiko Ito-Ihara, Takashi Kida, Nobuyuki Yajima, Takashi Kawaguchi, Isao Matsumoto
発行年月	2026/01
概要	OBJECTIVES:Rituximab (RTX) is a key treatment for ANCA-associated vasculitis (AAV), but RTX-induced acute thrombocytopenia (RIAT) remains a concern. We aimed to evaluate the risk and risk factors of RIAT in patients with AAV undergoing RTX induction therapy.METHODS:Patients with new-onset microscopic polyangiitis or granulomatosis with polyangiitis who received RTX in a nationwide multicentre registry in Japan were included. RIAT was defined by platelet count reductions within 28 days post-RTX. Risk factors for RIAT were identified by using logistic regression with stepwise selection, and prediction models were developed. Model performance was assessed using C-statistics.RESULTS:Among 175 patients with AAV receiving RTX, RIAT occurred in 35.4% of them. Diabetes mellitus (odds ratio [OR] = 4.96), cardiac disease (OR = 3.57), low platelet count (OR = 1.04 per 104/μl decrease), increased serum creatinine (OR = 1.44 per 1 mg/dl increase), low albumin (OR = 2.33 per 1 g/dl decrease), and high KL-6 (OR = 1.09 per 100 U/ml increase) were identified as significant predictors. A predictive model incorporating these factors achieved a C-statistic of 0.817.CONCLUSION:RIAT is a frequent complication of RTX induction in patients with AAV, with diabetes mellitus and cardiac disease being strong risk factors. Our predictive model enables risk assessment for RIAT, allowing clinicians to optimize treatment strategies.
DOI	10.1093/rheumatology/keaf529
PMID	41071071