ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 0423

Urine and Plasma Complement Ba Levels During Flares of Nephritis in Patients with ANCA-Associated Vasculitis

Salem Almaani1, Huijuan Song2, Meshora Sthanithra2, Christopher Toy2, Anna Levesque2, Lynn Fussner3, Alexa Meara3, Haikady Nagaraja2, David Cuthbertson4, Nader Khalidi5, CURRY LEE MD KOENING6, Carol Langford7, Carol McAlear8, Larry Moreland9, Christian Pagnoux10, Philip Seo11, Antoine Sreih12, Kenneth Warrington13, Paul Monach14, Peter Merkel8, Brad Rovin3 and Dan Birmingham2, 1Ohio State University Medical Center, Columbus, OH, 2Ohio State university, Columbus, OH, 3Ohio State University Wexner Medical Center, Columbus, OH, 4University of South Florida, Tampa, FL, 5McMaster University, Hamilton, ON, Canada, 6LIMITED TO OFFICIAL UNIVERSITY DUTIES ONLY, Salt Lake City, UT, 7Cleveland Clinic, Moreland Hills, OH, 8University of Pennsylvania, Philadelphia, PA, 9University of Colorado, Denver, CO, 10Mount Sinai Hospital, Toronto, ON, Canada, 11Johns Hopkins University, Baltimore, MD, 12Univeristy of Pennsylvania, Philadelphia, PA, 13Mayo Clinic, Rochester, Minnesota, 14Brigham and Women's Hospital, Boston, MA

Meeting: ACR Convergence 2021

Keywords: , , ,

Session Information

Date: Saturday, November 6, 2021

Title: Vasculitis – ANCA-Associated Poster (0414–0436)

Session Type: Poster Session A

Session Time: 8:30AM-10:30AM

Background/Purpose: The alternative complement pathway has been implicated in the pathogenesis of ANCA-associated vasculitis (AAV), however it is not clear whether activation of complement occurs systemically or in affected organs such as the kidney. This study measured levels of urinary and plasma complement fragment Ba (uBa and pBa respectively) at multiple timepoints in patients with AAV.

Methods: Ba was measured by ELISA in serial samples of urine (uBa) and plasma (pBa) from 20 AAV patients who developed a renal flare, 20 who developed a non-renal flare, and 20 in long-term remission. Changes in Ba levels were modeled using linear mixed effect models.

Results: Cohort characteristics are given in Figure.1. uBa levels increased at renal flare, but did not increase at non-renal flare, and remained stable in long-term remission (Figure 2a). pBa levels were stable over time in all groups (Figure 2b). uBa correlated with renal AAV activity measured as the renal component of the BVAS score (R2= 0.33, p< 0.01) (Figure 3a), but did not correlate with the overall BVAS score during renal flare (R2= 0.13, p=0.12) or non-renal flare (R2= 0.10, p=0.22) (Figure 3b,c).

Conclusion: Urine, but not plasma, Ba levels increase at the time of a flare of renal disease in AAV, suggesting intra-renal alternative complement pathway activation. uBa has the potential for use as a surveillance biomarker of renal vasculitis.

Disclosures: S. Almaani, None; H. Song, None; M. Sthanithra, None; C. Toy, None; A. Levesque, None; L. Fussner, None; A. Meara, AbbVie, GlaxoSmithKline, Aurinia, 2; H. Nagaraja, None; D. Cuthbertson, None; N. Khalidi, Roche, 12, Advisory Board for GCA CME November 2020, BMS, 12, Clinical Trial (Investigator Initiated- BMS supplied drug only, no fees received from BMS), Sanofi, 12, Clinical Trial 2020 GCA and PMR, Abbvie, 12, Clinical Trial 2020-2021 GCA; C. KOENING, None; C. Langford, None; C. McAlear, None; L. Moreland, None; C. Pagnoux, Gsk, 2, 5, 6, Roche, 2, 5, 6, Otuska, 2, Pfizer, 5, 6, Chemocentryx, 2, Astrazeneca, 1; P. Seo, Amgen, 1, Janssen, 1; A. Sreih, Bristol-Myers Squibb, 3, Alexion, 11; K. Warrington, Eli Lilly, 5, Kiniksa, 5; P. Monach, Kiniksa, 1, Celgene, 2, Chemocentryx, 1; P. Merkel, AbbVie, 2, 5, AstraZeneca, 2, 5, Boeringher-Ingelheim, 2, 5, Bristol-Myers Squibb, 2, 5, ChemoCentryx, 2, 5, CSL Behring, 2, Dynacure, 2, Eicos, 2, EMDSerono, 2, Forbius, 2, 5, Genentech/Roche, 2, 5, Genzyme/Sanofi, 2, 5, GlaxoSmithKline, 2, 5, InflaRx, 2, 5, Jannsen, 2, Kiniksa, 2, Magenta, 2, Neutrolis, 2, Novartis, 2, Pfizer, 2, Sanofi, 5, Star Therapeutics, 2, Takeda, 2, Talaris, 2, UpToDate, 9; B. Rovin, GlaxoSmithKline, 2, 5; D. Birmingham, None.

To cite this abstract in AMA style:

Almaani S, Song H, Sthanithra M, Toy C, Levesque A, Fussner L, Meara A, Nagaraja H, Cuthbertson D, Khalidi N, KOENING C, Langford C, McAlear C, Moreland L, Pagnoux C, Seo P, Sreih A, Warrington K, Monach P, Merkel P, Rovin B, Birmingham D. Urine and Plasma Complement Ba Levels During Flares of Nephritis in Patients with ANCA-Associated Vasculitis [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/urine-and-plasma-complement-ba-levels-during-flares-of-nephritis-in-patients-with-anca-associated-vasculitis/. Accessed .

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