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	Association Between Bronchiectasis and Serious Infections in Microscopic Polyangiitis and Granulomatosis With Polyangiitis From the J-CANVAS.
掲載誌名	正式名：International journal of rheumatic diseases 略　 称：Int J Rheum Dis ISSNコード：1756185X/17561841
掲載区分	国外
巻・号・頁	29(2),pp.e70570
著者・共著者	Satoshi Omura, Takashi Kida, Hironori Inoue, Yuki Shimada, Daiki Nakagomi, Yoshiyuki Abe, 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, Isao Matsumoto, Toshihiko Takada, Toshiko Ito-Ihara, Nobuyuki Yajima, Takashi Kawaguchi, Takahiro Seno, Masataka Kohno, Makoto Wada, Yutaka Kawahito
発行年月	2026/02
概要	BACKGROUND:Bronchiectasis is known to be more frequently observed in patients with microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) compared to the general population. However, its association with patient outcomes and the potential influence of immunosuppressive treatment on this association remain unclear.METHODS:We conducted a multicenter observational study using data from the Japan Collaborative Registry of ANCA-Associated Vasculitis (J-CANVAS). Adult patients with newly diagnosed or relapsing MPA or GPA between January 2017 and March 2023 were included. The exposure was clinically apparent bronchiectasis at baseline. Primary outcomes were serious infections and all-cause mortality; relapses were examined as a secondary outcome over 52 weeks. For each outcome, incidence rate ratios (IRRs) were estimated using multivariable Poisson regression models conditioned on confounding factors, incorporating follow-up time as an offset term. Interactions between initial treatment (prednisone dose, rituximab, cyclophosphamide, intravenous methylprednisolone, and plasma exchange) and bronchiectasis were also evaluated.RESULTS:Among 844 patients (MPA: 614; GPA: 230), 68 (8.1%) had bronchiectasis. During the follow-up period, there were 122 serious infections among 101 patients, 48 deaths, and 85 relapses among 72 patients. Adjusted IRRs for patients with bronchiectasis were 2.18 (95% CI: 1.25-3.83) for serious infections, 3.07 (1.41-6.66) for mortality, and 1.58 (0.77-3.24) for relapse. No clear interaction was detected between specific treatments and bronchiectasis.CONCLUSIONS:Bronchiectasis was associated with increased risks of serious infections and mortality in patients with MPA and GPA. However, we did not detect clear interaction by initial treatment, suggesting that avoiding specific therapies may not be necessary.
DOI	10.1111/1756-185x.70570
PMID	41672947