Comparison of the efficacy of high dosage methylprednisolone and plasmapheresis treatment in patients with ANCA associated vasculitis

Objective To compare the clinical efficacy and side-effects of high dosage methylprednisolone combined with plasmapheresis or only with high dosage methylprednisolone treatment in patients with anti-neutrophil cytoplasmic antibodies (ANCA) associated vasculitis (AAV). Methods Forty-seven patients with clinicopathologically diagnosed as ANCA-associated vasculitis kidney damage, whose clinical manifestations were also consistent with rapidly progressive glomerulonephritis syndrome, were treated with high dosage methylprednisolone and plasmapheresis (PE group, n=22) or only with high dosage methylprednisolone (MP group, n=25). Patients received these two regimes were comparable in general conditions and clinicopathological parameters for the activity and severity of renal damage. Results At the 6 month, the serum level of ANCA were both lower significantly than before (P 0.05). Three patients developed to end stage renal failure in each group during the follow-up period. The incidences of gastrointestinal symptoms (12.0% and 9.1% in MP and PE group, respectively) and infectious complications (28.0% and 22.7% in MP and PE group, respectively) were similar between two groups. Conclusions Both the high dosage methylprednisolone combined with plasmapheresis treatment and the high dosage methylprednisolone treatment have significant effects on patients with ANCA associated vasculitis, while the high dosage methylprednisolone combined with plasmapheresis treatment may be more effective in decreasing serum level of ANCA and improving renal function . Key words: Plasmapheresis; Methylprednisolone; Antibodies, antineutrophil cytoplasmic; Vasculitis