Successful Treatment of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis With Eicosapentaenoic Acid
Authors: Junichi Hirahashi, Airi Jo, Kohei Ueda, Akihiro Tojo, Toshiro Fujita
Journal: Annals of Internal Medicine (2012)

Letters15 May 2012Successful Treatment of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis With Eicosapentaenoic AcidJunichi Hirahashi, MD, PhD, Airi Jo, MD, Kohei Ueda, MD, Akihiro Tojo, MD, PhD, and Toshiro Fujita, MD, PhDJunichi Hirahashi, MD, PhDFrom Graduate School of Medicine, The University of Tokyo, 1138655 Tokyo, Japan., Airi Jo, MDFrom Graduate School of Medicine, The University of Tokyo, 1138655 Tokyo, Japan., Kohei Ueda, MDFrom Graduate School of Medicine, The University of Tokyo, 1138655 Tokyo, Japan., Akihiro Tojo, MD, PhDFrom Graduate School of Medicine, The University of Tokyo, 1138655 Tokyo, Japan., and Toshiro Fujita, MD, PhDFrom Graduate School of Medicine, The University of Tokyo, 1138655 Tokyo, Japan.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-10-201205150-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis is a life-threatening autoimmune disease that often causes inflammatory lesions in the kidneys and lungs. The current standard treatment combines steroids and cyclophosphamide to induce and maintain remission, but this treatment frequently causes adverse events that limit its efficacy (1).Objective: To successfully induce remission of ANCA-associated vasculitis with an alternative treatment by using eicosapentaenoic acid (EPA) without steroids or immunosuppressants.Case Report: An 80-year-old woman with aortic stenosis severe enough to cause syncope 1 year earlier presented with rapidly declining renal function. Her history included angina pectoris and myocardial infarction, and she was ...References1. Bosch X, Guilabert A, Espinosa G, Mirapeix E. Treatment of antineutrophil cytoplasmic antibody associated vasculitis: a systematic review. JAMA. 2007;298:655-69. [PMID: 17684188] CrossrefMedlineGoogle Scholar2. Serhan CN, Clish CB, Brannon J, Colgan SP, Chiang N, Gronert K. Novel functional sets of lipid-derived mediators with antiinflammatory actions generated from omega-3 fatty acids via cyclooxygenase 2-nonsteroidal antiinflammatory drugs and transcellular processing. J Exp Med. 2000;192:1197-204. [PMID: 11034610] CrossrefMedlineGoogle Scholar3. Yokoyama M, Origasa H, Matsuzaki M, Matsuzawa Y, Saito Y, Ishikawa Y, et al; Japan EPA lipid intervention study (JELIS) Investigators. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet. 2007;369:1090-8. [PMID: 17398308] CrossrefMedlineGoogle Scholar4. Little MA, Nightingale P, Verburgh CA, Hauser T, De Groot K, Savage C, et al; European Vasculitis Study (EUVAS) Group. Early mortality in systemic vasculitis: relative contribution of adverse events and active vasculitis. Ann Rheum Dis. 2010;69:1036-43. [PMID: 19574233] CrossrefMedlineGoogle Scholar5. Jones RB, Tervaert JW, Hauser T, Luqmani R, Morgan MD, Peh CA, et al; European Vasculitis Study Group. Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis. N Engl J Med. 2010;363:211-20. [PMID: 20647198] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Junichi Hirahashi, MD, PhD; Airi Jo, MD; Kohei Ueda, MD; Akihiro Tojo, MD, PhD; Toshiro Fujita, MD, PhDAffiliations: From Graduate School of Medicine, The University of Tokyo, 1138655 Tokyo, Japan.Acknowledgment: The authors thank Makoto Arita and Keiichi Hishikawa for pharmacologic assistance; Masaomi Nangaku and George Seki for supervision and critical reading of the manuscript; and Ai Furuta for a vigorous clinical practice.Grant Support: This work was supported in part by grants from the Ministry of Health, Labour and Welfare of Japan.Disclosures: The authors have applied for patents for the use of EPA to treat ANCA-associated vasculitis. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDietary intake of n-3 polyunsaturated fatty acids alters the lipid mediator profile of the kidney but does not attenuate renal insufficiencyOmega-3 Polyunsaturated Fatty Acids for the Treatment of IgA NephropathyAspirin and Eicosapentaenoic Acid May Arrest Progressive IgA Nephropathy: A Potential Alternative to ImmunosuppressionImmunomodulation with eicosapentaenoic acid supports the treatment of autoimmune small-vessel vasculitis 15 May 2012Volume 156, Issue 10Page: 755-756KeywordsAdverse eventsAspirinCyclophosphamideImmunosuppressivesKidneysProteinuriaStenosisSteroidsToxicityVasculitis ePublished: 15 May 2012 Issue Published: 15 May 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...