{"id":40060,"date":"2020-02-13T23:02:43","date_gmt":"2020-02-14T04:02:43","guid":{"rendered":"https:\/\/www.med.unc.edu\/medicine\/?p=40060"},"modified":"2023-06-06T17:50:41","modified_gmt":"2023-06-06T21:50:41","slug":"derebail-falk-suggest-in-new-england-journal-of-medicine-that-plasma-exchange-continue-as-induction-therapy-for-select-patients-with-anca-vasculitis","status":"publish","type":"post","link":"https:\/\/www.med.unc.edu\/medicine\/news\/derebail-falk-suggest-in-new-england-journal-of-medicine-that-plasma-exchange-continue-as-induction-therapy-for-select-patients-with-anca-vasculitis\/","title":{"rendered":"Derebail, Falk Publish Commentary in New England Journal of Medicine"},"content":{"rendered":"<figure id=\"attachment_40064\" class=\"thumbnail wp-caption alignright\" style=\"width: 196px\"><img loading=\"lazy\" decoding=\"async\" class=\" wp-image-40064\" src=\"https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2020\/02\/vimal-derenbail-240x300.jpg\" alt=\"vimal-derenbail\" width=\"186\" height=\"233\" srcset=\"https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2020\/02\/vimal-derenbail-240x300.jpg 240w, https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2020\/02\/vimal-derenbail-819x1024.jpg 819w, https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2020\/02\/vimal-derenbail-768x960.jpg 768w, https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2020\/02\/vimal-derenbail-1229x1536.jpg 1229w, https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2020\/02\/vimal-derenbail-1638x2048.jpg 1638w, https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2020\/02\/vimal-derenbail-600x750.jpg 600w, https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2020\/02\/vimal-derenbail-301x376.jpg 301w, https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2020\/02\/vimal-derenbail.jpg 1756w\" sizes=\"auto, (max-width: 186px) 100vw, 186px\" \/><figcaption class=\"caption wp-caption-text\">Vimal Derebail, MD, MPH<\/figcaption><\/figure>\n<p>After a review of the\u00a0<a href=\"https:\/\/secure-web.cisco.com\/154PY4ZBqk3v1buLiF1_xtD7zJGrnWrjzj1nAKr7hT8PqnyfQiBKV-h4rU_3woZ0hRHB3W1YOTEBN4OmIhItIrni0kDbBb_QGf6IWiKifuART3iLfBEGFZNl65XpuujfDYkgI5bfDNrxE72Maj5WPx4D4cHv2pJGTS2ul_whM3rt_6gKzewsOEoe55Tq1ztjBqqvIHLZFnGfZls2okEGCzji6i50GVS-9ExpM6BfojGUFkwbZgqfh2NCQ3l3u6gTzzsI3JdmwRyxq46q4ruLLnoGFUriJD9EeHr81vGwrHu8ROtWKHXhDyY-7QrBpObZqTbvJC9tuy8VUx0WlF83IfuDHMjcYicH_Y-J4T2Is_t7VQdZLtlaKUODB9Lv5PuB2DWbh3_Ef2eNrUlvrD9JEYQ\/https%3A%2F%2Facrabstracts.org%2Fabstract%2Fthe-effects-of-plasma-exchange-and-reduced-dose-glucocorticoids-during-remission-induction-for-treatment-of-severe-anca-associated-vasculitis%2F\">PEXIVAS<\/a>\u00a0trial, a large randomized clinical trial involving patients with ANCA vasculitis,\u00a0<a href=\"https:\/\/www.med.unc.edu\/medicine\/directory\/vimal-derebail\/\">Vimal K. Derebail<\/a>, MD, MPH, associate professor of medicine in the division of nephrology and hypertension, and <a href=\"https:\/\/www.med.unc.edu\/medicine\/directory\/ronald-falk\/\">Ronald J. Falk<\/a>, MD, chair of the UNC Department of Medicine, have published their interpretation of these findings for patients with severe ANCA vasculitis and ANCA-induced pulmonary hemorrhage.<\/p>\n<p>In the New England Journal of Medicine, the authors report \u201cplasma exchange has been a mainstay of induction therapy for patients with antineutrophil cyto-plasmic antibody (ANCA) vasculitis, who have rapidly progressive glomerulonephritis or diffuse alveolar hemorrhage,\u201d and that \u201cclinical data, in vitro data, and data from studies in animals have shown that ANCAs are pathogenic,\u201d and\u00a0plasma exchange\u00a0should \u201ctheoretically diminish vascular injury and end-organ damage, and hasten resolution of disease.\u201d\u00a0The PEXIVAS study found that adding plasma exchange to current standard of care provided no added benefit on the combined outcome of death and end-stage kidney disease.<\/p>\n<figure id=\"attachment_4459\" class=\"thumbnail wp-caption alignright\" style=\"width: 204px\"><img loading=\"lazy\" decoding=\"async\" class=\" wp-image-4459\" src=\"https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2018\/12\/ronald-j-falk-md-received-the-distinguished-john-p-peters-award-from-the-american-society-of-nephrology-image2-232x300.jpeg\" alt=\"Ronald Falk, MD\" width=\"194\" height=\"251\" srcset=\"https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2018\/12\/ronald-j-falk-md-received-the-distinguished-john-p-peters-award-from-the-american-society-of-nephrology-image2-232x300.jpeg 232w, https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2018\/12\/ronald-j-falk-md-received-the-distinguished-john-p-peters-award-from-the-american-society-of-nephrology-image2-791x1024.jpeg 791w, https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2018\/12\/ronald-j-falk-md-received-the-distinguished-john-p-peters-award-from-the-american-society-of-nephrology-image2-768x994.jpeg 768w, https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2018\/12\/ronald-j-falk-md-received-the-distinguished-john-p-peters-award-from-the-american-society-of-nephrology-image2-1187x1536.jpeg 1187w, https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2018\/12\/ronald-j-falk-md-received-the-distinguished-john-p-peters-award-from-the-american-society-of-nephrology-image2-600x777.jpeg 600w, https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2018\/12\/ronald-j-falk-md-received-the-distinguished-john-p-peters-award-from-the-american-society-of-nephrology-image2-301x390.jpeg 301w, https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2018\/12\/ronald-j-falk-md-received-the-distinguished-john-p-peters-award-from-the-american-society-of-nephrology-image2.jpeg 1553w\" sizes=\"auto, (max-width: 194px) 100vw, 194px\" \/><figcaption class=\"caption wp-caption-text\">Ronald Falk, MD<\/figcaption><\/figure>\n<p>They acknowledge the trial provides useful insights into induction therapy for ANCA vasculitis. \u00a0The PEXIVAS findings indicate that plasma exchange should not be used routinely in patients with ANCA vasculitis who have severe kidney dysfunction and indicate less glucocorticoid can be used for treatment of this disease. However, due to some limitations in the study, they suggest plasma exchange may still benefit selected subgroups of patients including those who do not have extensive pre-existing scarring. In the end, they suggest plasma exchange remain part of the induction regimen for patients with ANCA-induced pulmonary hemorrhage until a study specifically designed to evaluate efficacy in patients with pulmonary hemorrhage has been performed.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>After a review of the\u00a0PEXIVAS\u00a0trial, a large randomized clinical trial involving patients with ANCA vasculitis,\u00a0Vimal K. Derebail, MD, MPH, associate professor of medicine in the division of nephrology and hypertension, and Ronald J. Falk, MD, chair of the UNC Department of Medicine, have published their interpretation of these findings for patients with severe ANCA vasculitis &hellip; <a href=\"https:\/\/www.med.unc.edu\/medicine\/news\/derebail-falk-suggest-in-new-england-journal-of-medicine-that-plasma-exchange-continue-as-induction-therapy-for-select-patients-with-anca-vasculitis\/\" aria-label=\"Read more about Derebail, Falk Publish Commentary in New England Journal of Medicine\">Read more<\/a><\/p>\n","protected":false},"author":69419,"featured_media":40064,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"layout":"","cellInformation":"","apiCallInformation":"","footnotes":"","_links_to":"","_links_to_target":""},"categories":[101,2],"tags":[629],"class_list":["post-40060","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nephrology","category-news","tag-629","odd"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Derebail, Falk Publish Commentary in New England Journal of Medicine | Department of Medicine<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.med.unc.edu\/medicine\/news\/derebail-falk-suggest-in-new-england-journal-of-medicine-that-plasma-exchange-continue-as-induction-therapy-for-select-patients-with-anca-vasculitis\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Derebail, Falk Publish Commentary in New England Journal of Medicine | Department of Medicine\" \/>\n<meta property=\"og:description\" content=\"After a review of the\u00a0PEXIVAS\u00a0trial, a large randomized clinical trial involving patients with ANCA vasculitis,\u00a0Vimal K. Derebail, MD, MPH, associate professor of medicine in the division of nephrology and hypertension, and Ronald J. Falk, MD, chair of the UNC Department of Medicine, have published their interpretation of these findings for patients with severe ANCA vasculitis &hellip; Read more\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.med.unc.edu\/medicine\/news\/derebail-falk-suggest-in-new-england-journal-of-medicine-that-plasma-exchange-continue-as-induction-therapy-for-select-patients-with-anca-vasculitis\/\" \/>\n<meta property=\"og:site_name\" content=\"Department of Medicine\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/UNCDeptMedicine\" \/>\n<meta property=\"article:published_time\" content=\"2020-02-14T04:02:43+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-06T21:50:41+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2020\/02\/vimal-derenbail.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1756\" \/>\n\t<meta property=\"og:image:height\" 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