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Biomarkers Predict Relapse in Granulomatosis with Polyangiitis
Patrick C P Hogan1, Robert M O'Connell1, Simone Scollard2
1Department of Immunology, Trinity College Dublin, St. James's Hospital, Dublin 8, Ireland.
Journal of Biomarkers
|August 29, 2015
Summary
Predicting Granulomatosis with polyangiitis (GPA) relapse is crucial. Monitoring C-reactive protein (CRP), anti-PR3 antibodies, and neutrophil count together can predict up to 59% of GPA relapses, aiding early intervention.
Area of Science:
- Rheumatology
- Immunology
- Vasculitis Research
Background:
- Granulomatosis with polyangiitis (GPA) is a severe small vessel vasculitis.
- Disease relapse is common and leads to significant end-organ damage.
- Current biomarkers, including anti-neutrophil cytoplasmic antibody (ANCA) and anti-PR3 antibodies, are insufficient for reliable relapse prediction.
Purpose of the Study:
- To assess the predictive value of common laboratory tests for GPA relapse.
- To identify a combination of markers that can reliably indicate impending disease relapse.
Main Methods:
- Retrospective analysis of 30 GPA patients with 66 documented relapse episodes.
- Evaluation of changes in C-reactive protein (CRP), anti-PR3 antibody levels, ANCA titre, and neutrophil count preceding relapse.
- Development of a novel clinical yield score based on combined marker changes.
Main Results:
- A combined increase in CRP, anti-PR3 antibodies, and neutrophil count within six months prior to relapse predicted 59% of GPA relapse episodes.
- This combination of markers demonstrated utility in identifying patients at higher risk of relapse.
Conclusions:
- Monitoring changes in CRP, anti-PR3 antibodies, and neutrophil count offers a valuable tool for predicting GPA relapse.
- Early identification of relapse through these combined parameters can help limit end-organ damage in GPA patients.
