Association between serum syndecan-1 levels and relapse in patients with ANCA-associated vasculitis: A retrospective cohort study in Japan

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Abstract Title *

Association between serum syndecan-1 levels and relapse in patients with ANCA-associated vasculitis: A retrospective cohort study in Japan

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Co-author 1

Hirokazu Sugiyama sugiyama.hirokazu.283@mail.aichi-med-u.ac.jp Aichi Medical University Nephrology and Rheumatology Nagakute Japan -

Co-author 2

Kentaro Imai imai.kentarou.143@mail.aichi-med-u.ac.jp Aichi Medical University Nephrology and Rheumatology Nagakute Japan -

Co-author 3

Hiroshi Kinashi kinashi.hiroshi.909@mail.aichi-med-u.ac.jp Aichi Medical University Nephrology and Rheumatology Nagakute Japan -

Co-author 4

Keisuke Kamiya kamiya.keisuke.010@mail.aichi-med-u.ac.jp Aichi Medical University Nephrology and Rheumatology Nagakute Japan -

Co-author 5

Takayuki Katsuno t-katsuno@aichi-med-u.ac.jp Aichi Medical University Medical Centre Nephrology and Rheumatology Okazaki Japan -

Co-author 6

Shogo Banno sbannos@aichi-med-u.ac.jp Aichi Medical University Nephrology and Rheumatology Nagakute Japan -

Co-author 7

Yasuhiko Ito yasuito@aichi-med-u.ac.jp Aichi Medical University Nephrology and Rheumatology Nagakute Japan -

Co-author 8

Takuji Ishimoto i-takuji@med.nagoya-u.ac.jp Aichi Medical University Nephrology and Rheumatology Nagakute Japan -

Co-author 9

Makoto Yamaguchi makoto.yu.1107@gmail.com Aichi Medical University Nephrology and Rheumatology Nagakute Japan *

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Despite published reports on evaluation of the risk factors for relapse in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV), the relationship between serum syndecan-1 levels and AAV relapse has not been previously evaluated. We hypothesised that patients with AAV and high serum syndecan-1 levels are at a higher risk of relapse. We therefore investigated the association between serum syndecan-1 levels at AAV diagnosis and subsequent relapse in patients with AAV.

Methods

This single-centre retrospective cohort study included 60 consecutive patients with microscopic polyangiitis and granulomatosis with polyangiitis treated at Aichi Medical University Hospital in Japan between 2018 and 2022. The relationship between serum syndecan-1 levels at diagnosis and subsequent first relapse was assessed using multivariable Cox proportional hazards models. The cumulative probability of relapse was calculated using the Kaplan–Meier method and log-rank test. Statistical significance was set at P < 0.05.

Results

During a median follow-up period of 48 (24‒64) months, 20 (33.3%) patients experienced at least one relapse. High serum syndecan-1 level (adjusted HR = 19.6, 95% CI: 1.26–303.6, vs. low serum syndecan-1 level) was a significant predictor of relapse.

Conclusion

High serum syndecan-1 level was associated with an increased risk of relapse in patients with AAV. Further studies are needed to elucidate the optimal treatment strategy to reduce relapse in patients with AAV.

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