Publications by authors named "X Puechal"

Background: The PEXIVAS (Plasma exchange and glucocorticoids in severe antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis) trial showed that a reduced-dose glucocorticoid regimen (redGC) was non-inferior to a standard-dose regimen (standGC) with respect to death or end-stage kidney disease (ESKD) in patients with ANCA-associated vasculitis (AAV). However, the primary endpoint did not include disease progression or relapse, cyclophosphamide was the main induction therapy and rituximab (RTX)-treated patients tended to have a higher risk of death or ESKD with redGC. We aimed to evaluate the real-world use of redGC.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to assess the effectiveness of combining glucocorticoids (GCs) with cyclophosphamide (CYC) for treating patients with poor-prognosis eosinophilic granulomatosis with polyangiitis (EGPA) compared to using GCs alone.
  • Data from a European multicenter database were analyzed, involving 209 patients and focusing on relapse rates and other related outcomes over 12 to 24 months.
  • Results indicated that adding CYC significantly reduced the risk of relapse and related complications compared to GCs alone, suggesting a beneficial role for CYC in the treatment of poor-prognosis EGPA.
View Article and Find Full Text PDF

Background: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a heterogenous autoimmune disease. While traditionally stratified into two conditions, granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), the subclassification of ANCA-associated vasculitis is subject to continued debate. Here we aim to identify phenotypically distinct subgroups and develop a data-driven subclassification of ANCA-associated vasculitis, using a large real-world dataset.

View Article and Find Full Text PDF

Targeted therapy has revolutionized the management of ANCA-associated vasculitis (AAV) over the last fifteen years. Rituximab, an approved induction and maintenance agent for severe AAV, is no less effective than cyclophosphamide as induction therapy and particularly useful in relapsing or refractory disease, or in women. In patients with relapsing AAV, granulomatosis with polyangiitis or PR3-ANCA, it is more effective than cyclophosphamide.

View Article and Find Full Text PDF

Objective: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) primarily affects small vessels. Large-vessel involvement (LVI) is rare. We aimed to describe the characteristics of LVI, to identify associated risk factors, and to describe its therapeutic management.

View Article and Find Full Text PDF