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This trial showed that plasma exchange did not delay onset of end-stage renal disease or death and reduced oral steroid dosing was no less effective than the standard dose.
1 Department of Medicine, University of Cambridge, Cambridge, UK
2 Department of Nephrology, McMaster University, Hamilton, ON, Canada
3 Department of Rheumatology, University of Pennsylvania, Philadelphia, PA, USA
4 Royal Adelaide Hospital, Adelaide, SA, Australia
5 Department of Nephrology, Rigshospitalet, Copenhagen, Denmark
6 National Referral Centre for Rare Systemic Autoimmune Diseases, Cochin Hospital, Assistance Publique–Hôpitaux de Paris, Paris, France
7 Department of Hemovascular Medicine and Artificial Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
8 Department of Nephrology, The University of Queensland, Brisbane, QLD, Australia
9 Department of Rheumatology, McMaster University, Hamilton, ON, Canada
10 Renal Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
11 Renal Unit, Royal Berkshire Hospital, Reading, UK
12 Department of Rheumatology, St Michael’s Hospital, Toronto, ON, Canada
13 Department of Nephrology, University of Calgary, Calgary, AB, Canada
14 Department of Nephrology, St Paul’s Hospital, Vancouver, BC, Canada
15 Department of Nephrology, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
16 Department of Nephrology, University of Birmingham, Birmingham, UK
17 Department of Nephrology, University of Western Ontario, London, ON, Canada
18 Department of Rheumatology, Mount Sinai Hospital, Toronto, ON, Canada
19 Department of Pulmonary Medicine, Mayo Clinic, Rochester, MN, USA
20 Department of Nephrology, The Royal Devon and Exeter Hospital, Exeter, UK
21 Clinical and Translational Research Centre, Kyoto Prefecture University of Medicine, Kyoto, Japan
22 Department of Nephrology, North Shore Hospital, Auckland, New Zealand
23 The Research Institute, St Joseph’s Healthcare, Hamilton, ON, Canada
24 Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia
25 Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
26 Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
27 Department of Nephrology, Imperial College London, London, UK
* Corresponding author Email: dj106@cam.ac.uk
Declared competing interests of authors: David Jayne has received research grants from Chemocentryx Inc. (San Carlos, CA, USA), GlaxoSmithKline (Brentford, UK), Roche Holding AG (Basel, Switzerland)/Genentech (South San Francisco, CA, USA) and Sanofi (Paris, France)/Genzyme (Cambridge, MA, USA); has received consultancy fees from AstraZeneca (Cambridge, UK), Boehringer Ingelheim (Ingelheim am Rhein, Germany), Chemocentryx Inc., GlaxoSmithKline, InflaRx (Jena, Germany), Insmed Inc. (Bridgewater Township, NJ, USA), Roche Holding AG/Genentech and Vifor Pharma (Opfikon, Switzerland); and was a member of the Efficacy and Mechanism Evaluation (EME) Prioritisation Group (2012–16) and EME Strategy Group (2015–18). Michael Walsh was supported by a New Investigator Award from the Canadian Institutes of Health Research, and reports other funding from Bayer HealthCare (Leverkusen, Germany) and Ionis Pharmaceuticals (Carlsbad, CA, USA) outside the submitted work. Peter A Merkel reports receiving consulting fees from AbbVie (Lake Bluff, IL, USA), Biogen Inc. (Cambridge, MA, USA), CSL Behring (King of Prussia, PA, USA), Genzyme, Insmed Inc. (Bridgewater Township, NJ, USA), Janssen Pharmaceuticals (Beerse, Belgium), Kiniksa Pharmaceuticals (Bermuda) and Sparrow (Portland, OR, USA); grant support and consulting fees from AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb (New York, NY, USA), Celgene (Summit, NJ, USA), Chemocentryx Inc., Genentech/Roche Holding AG, GlaxoSmithKline (Brentford, UK) and InflaRx; grant support from Kypha Inc. (St. Louis, MO, USA); and supplies from Terumo BCT, Inc. (Lakewood, CO, USA). Xavier Puéchal reports personal fees and non-financial support from Roche Holding AG, personal fees from Pfizer Inc. (New York, NY, USA) and LFB (Paris, France) and non-financial support from Sanofi outside the submitted work. Shouichi Fujimoto reports receiving equipment related to plasma exchange from Asahi Kasei Medical Co., Ltd (Tokyo, Japan). Carmel Hawley reports consumables from Terumo BCT (Lakewood, CO, USA), Fresenius (Bad Homburg, Germany) and Gambro (Deerfield, IL, USA); and grants from The National Health and Medical Research Council (NHMRC) Australia (26939, 2010–13, and 1086192, 2014–17), Shire (Lexington, MA, USA) and Amgen (Thousand Oaks, CA, USA) during the conduct of the study. Nader Khalidi reports advisory board fees and study drugs from Roche Holding AG and study drugs from Bristol-Myers Squibb outside the submitted work. Rachel Jones reports personal fees from Chemocentryx Inc. and grants from GlaxoSmithKline outside the submitted work. Christian Pagnoux reports grants and personal fees from Roche Holding AG, personal fees from Sanofi and Chemocentryx Inc. outside the submitted work. Toshiko Ito-Ihara reports receiving equipment related to plasma exchange from Asahi Kasei Medical Co., Ltd. Donna Reidlinger reports consumables from Terumo BCT, Inc., Fresenius (Bad Homburg, Germany) and Gambro, and grants from NHMRC (Canberra, ACT, Australia) (626939, 2010–13, and 1086192, 2014–17) during the conduct of the study. Keith Wheatley reports membership of the Health Technology Assessment (HTA) Clinical Trials Committee (2012–17).
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