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March 9, 2011

Preventing Relapses in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis

JAMA. 2011;305(10):996-997. doi:10.1001/jama.2011.238

To the Editor: The recent multicenter randomized controlled trial by Dr Hiemstra and colleagues compares the effects of mycophenolate mofetil with azathioprine on the prevention of relapses in patients with antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV).1 The authors reported that mycophenolate mofetil is less effective than azathioprine for maintaining disease remission (unadjusted hazard ratio for relapse with mycophenolate mofetil, 1.69; 95% confidence interval, 1.06-2.70), and they concluded that mycophenolate mofetil should not be considered the first-line remission maintenance therapy in AAV.