Phase
Condition
Lupus
Vascular Diseases
Collagen Vascular Diseases
Treatment
N/AClinical Study ID
Ages > 15 All Genders
Study Summary
Eligibility Criteria
Inclusion
Inclusion Criteria:
• New or previous clinical diagnosis of granulomatosis with polyangiitis or microscopicpolyangiitis consistent with the Chapel-Hill consensus definitions AND
• Positive test for proteinase 3-ANCA or myeloperoxidase-ANCA AND
- Severe vasculitis defined by at least one of the following:
- Renal involvement with both:
Renal biopsy demonstrating focal necrotizing glomerulonephritis or activeurine sediment characterized by glomerular haematuria or red cell casts andproteinuria AND
eGFR <50 ml/min/1.73 m2
- Pulmonary hemorrhage due to active vasculitis defined by:
A compatible chest x-ray or CT scan (diffuse pulmonary infiltrates) AND
The absence of an alternative explanation for all pulmonary infiltrates (e.g. volume overload or pulmonary infection) AND
- At least one of the following:
Evidence of alveolar hemorrhage on bronchoscopic examination or increasinglybloody returns with bronchoalveolar lavage
Observed hemoptysis
Unexplained anemia (<10 g/dL) or documented drop in hemoglobin >1 g/dL)
Increased diffusing capacity of carbon dioxide
Provision of informed consent by patient or a surrogate decision maker
Exclusion
Exclusion Criteria:
A diagnosis of vasculitis other than granulomatosis with polyangiitis or microscopicpolyangiitis
Positive anti-glomerular basement membrane antibody test or renal biopsy demonstratinglinear glomerular immunoglobulin deposition
Receipt of dialysis for >21 days immediately prior to randomization or prior renaltransplant
Age <15 years
Pregnancy
Inability or unwillingness to comply with birth control/abstinence
Treatment with >1 IV dose of cyclophosphamide and/or >14 days of oral cyclophosphamideand/or >14 days of prednisone/prednisolone (>30 mg/day) and/or >1 dose of rituximabwithin the 28 days immediately prior to randomization
A comorbidity that, in the opinion of the investigator, precludes the use ofcyclophosphamide, glucocorticoids, or plasma exchange or absolutely mandates the useof plasma exchange