{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T02:28:15Z","timestamp":1790130495979,"version":"4.0.1"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003790","name":"Hiroshima University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003790","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Rheumatol Int"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare clinicopathological phenotype-based, anti-neutrophil cytoplasmic antibody (ANCA) serotype-based, and unsupervised data-driven classifications in relation to clinical outcomes and patient heterogeneity in a large Japanese cohort with ANCA-associated vasculitis (AAV).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicentre, retrospective cohort study analysed data from a nationwide Japanese registry of 729 newly diagnosed patients with granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA), all positive for myeloperoxidase (MPO)- or proteinase 3 (PR3)-ANCA. Patients were classified by phenotype, serotype, combined phenotype-serotype groupings, and data-driven clustering based on baseline clinical and laboratory features. Associations with clinical outcomes\u2014including mortality, relapse, and response to rituximab (RTX) versus cyclophosphamide (IVCY)\u2014were evaluated using inverse probability of treatment weighting (IPW).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Phenotype-based classification more accurately distinguished all-cause mortality risk (MPA vs. GPA: hazard ratio [HR] 2.53, 95% CI 1.34\u20134.76). Combined phenotype-serotype analysis identified MPO-MPA patients with the highest mortality (HR 3.45, 95% CI 1.09-11.0, vs. PR3-GPA) and PR3-GPA with the highest severe relapse. Discordant groups, such as MPO-GPA, demonstrated unique clinical characteristics. After IPW adjustment, no significant difference in 24-week remission rates was observed between RTX and IVCY across classifications, both overall (RR 1.02, 95% CI 0.95\u20131.09) and within subgroups. Unsupervised clustering identified four distinct clinical subgroups, with limited concordance with conventional phenotype or serotype classifications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Phenotype and serotype classifications provide complementary, not competing, prognostic insights in Japanese patients with AAV. Data-driven clustering revealed additional clinical heterogeneity not captured by traditional systems, underscoring the need for integrated, multi-dimensional stratification approaches to improve personalised risk assessment and treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00296-025-06014-y","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T09:00:38Z","timestamp":1762938038000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Phenotype, serotype, and data-driven clustering reveal complementary dimensions of heterogeneity in ANCA-associated vasculitis: a multicentre Japanese cohort (J-CANVAS)"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0558-8814","authenticated-orcid":false,"given":"Genki","family":"Kidoguchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0774-0509","authenticated-orcid":false,"given":"Yusuke","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9187-2044","authenticated-orcid":false,"given":"Satoshi","family":"Omura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1682-9799","authenticated-orcid":false,"given":"Daiki","family":"Nakagomi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1014-2868","authenticated-orcid":false,"given":"Yoshiyuki","family":"Abe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Wada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3744-3537","authenticated-orcid":false,"given":"Naoho","family":"Takizawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8194-6273","authenticated-orcid":false,"given":"Atsushi","family":"Nomura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4074-4533","authenticated-orcid":false,"given":"Yuji","family":"Kukida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Kondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirosuke","family":"Takagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Endo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4773-1535","authenticated-orcid":false,"given":"Naoto","family":"Azuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0065-929X","authenticated-orcid":false,"given":"Tohru","family":"Takeuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoichi","family":"Fukui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuro","family":"Kamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Yanai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Matsuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7100-1121","authenticated-orcid":false,"given":"Yasuhiro","family":"Shimojima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Nishioka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Okazaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2959-6015","authenticated-orcid":false,"given":"Tomoaki","family":"Takata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayuko","family":"Moriyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayuko","family":"Takatani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6981-3443","authenticated-orcid":false,"given":"Yoshia","family":"Miyawaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6295-3494","authenticated-orcid":false,"given":"Tsuyoshi","family":"Shirai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2944-5583","authenticated-orcid":false,"given":"Hiroaki","family":"Dobashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0677-6566","authenticated-orcid":false,"given":"Takafumi","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7995-9294","authenticated-orcid":false,"given":"Isao","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8032-6224","authenticated-orcid":false,"given":"Toshihiko","family":"Takada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3860-0488","authenticated-orcid":false,"given":"Yutaka","family":"Kawahito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7152-3026","authenticated-orcid":false,"given":"Toshiko","family":"Ito-Ihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5740-8352","authenticated-orcid":false,"given":"Takashi","family":"Kida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8292-3962","authenticated-orcid":false,"given":"Nobuyuki","family":"Yajima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2446-7716","authenticated-orcid":false,"given":"Takashi","family":"Kawaguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2474-9943","authenticated-orcid":false,"given":"Shintaro","family":"Hirata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"6014_CR1","doi-asserted-by":"publisher","unstructured":"Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F et al (2013) 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheumatism 65:1\u201311. https:\/\/doi.org\/10.1002\/art.37715","DOI":"10.1002\/art.37715"},{"key":"6014_CR2","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1038\/s41584-022-00819-y","volume":"18","author":"G Trivioli","year":"2022","unstructured":"Trivioli G, Marquez A, Martorana D, Tesi M, Kronbichler A, Lyons PA et al (2022) Genetics of ANCA-associated vasculitis: role in pathogenesis, classification and management. Nat Rev Rheumatol 18:559\u2013574. https:\/\/doi.org\/10.1038\/s41584-022-00819-y","journal-title":"Nat Rev Rheumatol"},{"key":"6014_CR3","doi-asserted-by":"publisher","first-page":"2855","DOI":"10.3389\/fimmu.2019.02855","volume":"10","author":"ZS Wallace","year":"2019","unstructured":"Wallace ZS, Stone JH (2019) Personalized medicine in ANCA-Associated vasculitis ANCA specificity as the guide? Front Immunol 10:2855. https:\/\/doi.org\/10.3389\/fimmu.2019.02855","journal-title":"Front Immunol"},{"key":"6014_CR4","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1007\/s11926-021-01002-0","volume":"23","author":"M Windpessl","year":"2021","unstructured":"Windpessl M, Bettac EL, Gauckler P, Shin JI, Geetha D, Kronbichler A (2021) ANCA status or clinical Phenotype \u2014 What counts more? Curr Rheumatol Rep 23:37. https:\/\/doi.org\/10.1007\/s11926-021-01002-0","journal-title":"Curr Rheumatol Rep"},{"key":"6014_CR5","doi-asserted-by":"publisher","first-page":"1999","DOI":"10.1007\/s10067-025-07397-w","volume":"44","author":"L Zhang","year":"2025","unstructured":"Zhang L, Zhang J, Xu J, Guo Q, Zou Y, Zhang X et al (2025) Simplifying ANCA-associated vasculitis classification with ANCA specificity: a retrospective analysis. Clin Rheumatol 44:1999\u20132008. https:\/\/doi.org\/10.1007\/s10067-025-07397-w","journal-title":"Clin Rheumatol"},{"key":"6014_CR6","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1002\/art.41984","volume":"74","author":"C Dejaco","year":"2022","unstructured":"Dejaco C, Guillevin L (2022) New classification criteria for Small-Vessel vasculitis: is antineutrophil cytoplasmic antibody inclusion their major advance? Arthritis Rheumatol 74:383\u2013385. https:\/\/doi.org\/10.1002\/art.41984","journal-title":"Arthritis Rheumatol"},{"key":"6014_CR7","doi-asserted-by":"publisher","first-page":"1717","DOI":"10.1007\/s00296-021-04966-5","volume":"41","author":"M Dom\u00ednguez-Quintana","year":"2021","unstructured":"Dom\u00ednguez-Quintana M, Alba MA, Hinojosa-Azaola A (2021) Classification of ANCA-associated vasculitis: differences based on ANCA specificity and clinicopathologic phenotype. Rheumatol Int 41:1717\u20131728. https:\/\/doi.org\/10.1007\/s00296-021-04966-5","journal-title":"Rheumatol Int"},{"key":"6014_CR8","doi-asserted-by":"publisher","first-page":"e002160","DOI":"10.1136\/rmdopen-2021-002160","volume":"8","author":"X Pu\u00e9chal","year":"2022","unstructured":"Pu\u00e9chal X, Iudici M, Pagnoux C, Cohen P, Hamidou M, Aouba A et al (2022) Comparative study of granulomatosis with polyangiitis subsets according to ANCA status: data from the French vasculitis study group registry. RMD Open 8:e002160. https:\/\/doi.org\/10.1136\/rmdopen-2021-002160","journal-title":"RMD Open"},{"key":"6014_CR9","doi-asserted-by":"publisher","first-page":"2216","DOI":"10.1002\/art.42651","volume":"75","author":"JL Bloom","year":"2023","unstructured":"Bloom JL, Pickett-Nairn K, Silveira L, Fuhlbrigge RC, Cuthbertson D, Akuthota P et al (2023) The association between age at diagnosis and disease characteristics and damage in patients with ANCA-Associated vasculitis. Arthritis Rheumatol 75:2216\u20132227","journal-title":"Arthritis Rheumatol"},{"key":"6014_CR10","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1136\/ard-2022-223764","volume":"83","author":"B Hellmich","year":"2024","unstructured":"Hellmich B, Sanchez-Alamo B, Schirmer JH, Berti A, Blockmans D, Cid MC et al (2024) EULAR recommendations for the management of ANCA-associated vasculitis: 2022 update. Ann Rheum Dis 83:30\u201347. https:\/\/doi.org\/10.1136\/ard-2022-223764","journal-title":"Ann Rheum Dis"},{"key":"6014_CR11","doi-asserted-by":"publisher","first-page":"e762","DOI":"10.1016\/S2665-9913(24)00187-5","volume":"6","author":"K Gisslander","year":"2024","unstructured":"Gisslander K, White A, Aslett L, Hru\u0161kov\u00e1 Z, Lamprecht P, Musia\u0142 J et al (2024) Data-driven subclassification of ANCA-associated vasculitis: model-based clustering of a federated international cohort. Lancet Rheumatol 6:e762\u2013770. https:\/\/doi.org\/10.1016\/S2665-9913(24)00187-5","journal-title":"Lancet Rheumatol"},{"key":"6014_CR12","doi-asserted-by":"publisher","first-page":"1827","DOI":"10.1136\/ard.2008.101279","volume":"68","author":"C Mukhtyar","year":"2009","unstructured":"Mukhtyar C, Lee R, Brown D, Carruthers D, Dasgupta B, Dubey S et al (2009) Modification and validation of the Birmingham vasculitis activity score (version 3). Ann Rheum Dis 68:1827\u20131832. https:\/\/doi.org\/10.1136\/ard.2008.101279","journal-title":"Ann Rheum Dis"},{"key":"6014_CR13","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1136\/ard.2006.054593","volume":"66","author":"R Watts","year":"2007","unstructured":"Watts R, Lane S, Hanslik T, Hauser T, Hellmich B, Koldingsnes W et al (2007) Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies. Ann Rheum Dis 66:222\u2013227. https:\/\/doi.org\/10.1136\/ard.2006.054593","journal-title":"Ann Rheum Dis"},{"key":"6014_CR14","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1038\/nrrheum.2017.140","volume":"13","author":"X Bossuyt","year":"2017","unstructured":"Bossuyt X, Tervaert JWC, Arimura Y, Blockmans D, Flores-Su\u00e1rez LF, Guillevin L et al (2017) Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis. Nat Rev Rheumatol 13:683\u2013692. https:\/\/doi.org\/10.1038\/nrrheum.2017.140","journal-title":"Nat Rev Rheumatol"},{"key":"6014_CR15","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1080\/01621459.1999.10474144","volume":"94","author":"JP Fine","year":"1999","unstructured":"Fine JP, Gray RJ (1999) A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc 94:496\u2013509. https:\/\/doi.org\/10.1080\/01621459.1999.10474144","journal-title":"J Am Stat Assoc"},{"key":"6014_CR16","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1080\/01621459.2016.1260466","volume":"113","author":"F Li","year":"2018","unstructured":"Li F, Morgan KL, Zaslavsky AM (2018) Balancing covariates via propensity score weighting. J Am Stat Assoc 113:390\u2013400. https:\/\/doi.org\/10.1080\/01621459.2016.1260466","journal-title":"J Am Stat Assoc"},{"key":"6014_CR17","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1093\/ije\/dyaa213","volume":"50","author":"PWG Tennant","year":"2021","unstructured":"Tennant PWG, Murray EJ, Arnold KF, Berrie L, Fox MP, Gadd SC et al (2021) Use of directed acyclic graphs (DAGs) to identify confounders in applied health research: review and recommendations. Int J Epidemiol 50:620\u2013632. https:\/\/doi.org\/10.1093\/ije\/dyaa213","journal-title":"Int J Epidemiol"},{"key":"6014_CR18","doi-asserted-by":"publisher","first-page":"1887","DOI":"10.1093\/ije\/dyw341","volume":"45","author":"J Textor","year":"2016","unstructured":"Textor J, van der Zander B, Gilthorpe MS, Li\u015bkiewicz M, Ellison GT (2016) Robust causal inference using directed acyclic graphs: the R package \u2018dagitty\u2019. Int J Epidemiol 45:1887\u20131894. https:\/\/doi.org\/10.1093\/ije\/dyw341","journal-title":"Int J Epidemiol"},{"key":"6014_CR19","doi-asserted-by":"publisher","unstructured":"Ali MS, Prieto-Alhambra D, Lopes LC, Ramos D, Bispo N, Ichihara MY Propensity Score Methods in Health Technology Assessment: Principles, Extended Applications, and, Advances R et al (2019) Front Pharmacol 10:973. https:\/\/doi.org\/10.3389\/fphar.2019.00973","DOI":"10.3389\/fphar.2019.00973"},{"key":"6014_CR20","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1093\/aje\/kwh090","volume":"159","author":"G Zou","year":"2004","unstructured":"Zou G (2004) A modified Poisson regression approach to prospective studies with binary data. Am J Epidemiol 159:702\u2013706. https:\/\/doi.org\/10.1093\/aje\/kwh090","journal-title":"Am J Epidemiol"},{"key":"6014_CR21","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.csda.2012.12.008","volume":"71","author":"C Bouveyron","year":"2014","unstructured":"Bouveyron C, Brunet-Saumard C (2014) Model-based clustering of high-dimensional data: A review. Comput Stat Data Anal 71:52\u201378. https:\/\/doi.org\/10.1016\/j.csda.2012.12.008","journal-title":"Comput Stat Data Anal"},{"key":"6014_CR22","doi-asserted-by":"publisher","first-page":"289","DOI":"10.32614\/RJ-2016-021","volume":"8","author":"L Scrucca","year":"2016","unstructured":"Scrucca L, Fop M, Murphy TB, Raftery AE (2016) Mclust 5: Clustering, classification and density Estimation using Gaussian finite mixture models. R J 8:289\u2013317. https:\/\/doi.org\/10.32614\/RJ-2016-021","journal-title":"R J"},{"key":"6014_CR23","doi-asserted-by":"publisher","unstructured":"van der Laan MJ, Gruber S (2010) Collaborative double robust targeted maximum likelihood Estimation. Int J Biostat 6. :Article 17. https:\/\/doi.org\/10.2202\/1557-4679.1181","DOI":"10.2202\/1557-4679.1181"},{"key":"6014_CR24","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1136\/annrheumdis-2021-221795","volume":"81","author":"JC Robson","year":"2022","unstructured":"Robson JC, Grayson PC, Ponte C, Suppiah R, Craven A, Judge A et al (2022) 2022 American college of rheumatology\/European alliance of associations for rheumatology classification criteria for granulomatosis with polyangiitis. Ann Rheum Dis 81:315\u2013320. https:\/\/doi.org\/10.1136\/annrheumdis-2021-221795","journal-title":"Ann Rheum Dis"},{"key":"6014_CR25","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1002\/art.41983","volume":"74","author":"R Suppiah","year":"2022","unstructured":"Suppiah R, Robson JC, Grayson PC, Ponte C, Craven A, Khalid S et al (2022) 2022 American college of rheumatology\/European alliance of associations for rheumatology classification criteria for microscopic polyangiitis. Arthritis Rheumatol 74:400\u2013406. https:\/\/doi.org\/10.1002\/art.41983","journal-title":"Arthritis Rheumatol"},{"key":"6014_CR26","doi-asserted-by":"publisher","first-page":"1731","DOI":"10.1093\/rheumatology\/kez016","volume":"58","author":"S Deshayes","year":"2019","unstructured":"Deshayes S, Silva NM, Khoy K, Yameogo S, Mariotte D, Lobbedez T et al (2019) Clinical impact of subgrouping ANCA-associated vasculitis according to antibody specificity beyond the clinicopathological classification. Rheumatology 58:1731\u20131719. https:\/\/doi.org\/10.1093\/rheumatology\/kez016","journal-title":"Rheumatology"},{"key":"6014_CR27","doi-asserted-by":"publisher","first-page":"5223","DOI":"10.1038\/s41598-021-84627-6","volume":"11","author":"H Watanabe","year":"2021","unstructured":"Watanabe H, Sada K, ei, Harigai M, Amano K, Dobashi H, Takasaki Y et al (2021) Exploratory classification of clinical phenotypes in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis using cluster analysis. Sci Rep 11:5223. https:\/\/doi.org\/10.1038\/s41598-021-84627-6","journal-title":"Sci Rep"},{"key":"6014_CR28","doi-asserted-by":"publisher","first-page":"e70009","DOI":"10.1002\/acr2.70009","volume":"7","author":"H Lindberg","year":"2025","unstructured":"Lindberg H, Knight A, Hellbacher E, Norling O, Berglin E, Stegmayr B et al (2025) In-Depth analysis of disease manifestations in antineutrophil cytoplasmic Antibody\u2013Associated vasculitides identifies distinct clinical phenotypes. ACR Open Rheumatol 7:e70009. https:\/\/doi.org\/10.1002\/acr2.70009","journal-title":"ACR Open Rheumatol"},{"key":"6014_CR29","doi-asserted-by":"publisher","first-page":"1450153","DOI":"10.3389\/fimmu.2024.1450153","volume":"15","author":"Y Okazaki","year":"2025","unstructured":"Okazaki Y, Matsuda S, Kotani T, Fukui K, Gon T, Watanabe R et al (2025) Identification of novel clinical subtypes in patients with microscopic polyangiitis using cluster analysis: multicenter REVEAL cohort study. Front Immunol 15:1450153","journal-title":"Front Immunol"},{"key":"6014_CR30","doi-asserted-by":"publisher","unstructured":"van der Geest KSM, Brouwer E, Sanders JS, Sandovici M, Bos NA, Boots AMH et al (2018) Towards precision medicine in ANCA-associated vasculitis. Rheumatology 57:1332\u20131339. https:\/\/doi.org\/10.1093\/rheumatology\/kex36731","DOI":"10.1093\/rheumatology\/kex36731"},{"key":"6014_CR31","doi-asserted-by":"publisher","first-page":"5789","DOI":"10.1038\/s41467-023-41328-0","volume":"14","author":"M Nishide","year":"2023","unstructured":"Nishide M, Nishimura K, Matsushita H, Edahiro R, Inukai S, Shimagami H (2023) Single-cell multi-omics analysis identifies two distinct phenotypes of newly-onset microscopic polyangiitis. Nat Commun 14:5789. https:\/\/doi.org\/10.1038\/s41467-023-41328-0","journal-title":"Rheumatology"},{"key":"6014_CR32","doi-asserted-by":"publisher","first-page":"3691","DOI":"10.1093\/rheumatology\/keae661","volume":"64","author":"S Omura","year":"2025","unstructured":"Omura S, Kida T, Kronbichler A, Geetha D, Noma H, Seno T et al (2025) Differences in phenotypes, treatments, and outcomes of ANCA-associated vasculitis across Europe, Japan and the USA in 2020. Rheumatology 64:3691\u20133700. https:\/\/doi.org\/10.1093\/rheumatology\/keae661","journal-title":"Rheumatology"}],"container-title":["Rheumatology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00296-025-06014-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00296-025-06014-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00296-025-06014-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T06:40:49Z","timestamp":1765348849000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00296-025-06014-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,12]]},"references-count":32,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["6014"],"URL":"https:\/\/doi.org\/10.1007\/s00296-025-06014-y","relation":{},"ISSN":["1437-160X"],"issn-type":[{"value":"1437-160X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,12]]},"assertion":[{"value":"25 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Y. Yoshida has received speaker honoraria from Eisai, Asahi Kasei Pharma, Daiichi-Sankyo, AstraZeneca, Boehringer Ingelheim, AbbVie, Astellas Pharma, and Taisho Pharmaceutical. S. S. Omura has received speaker honoraria from Janssen Pharmaceutical and UCB Japan. H. Takagi has received speaker honoraria from Asahi-Kasei Pharma, Astellas Pharma, and Kissei Pharmaceutical, and travel\/accommodation support from Asahi-Kasei Pharma, Chugai Pharmaceutical, and Kissei Pharmaceutical. N. Azuma has received speaker honoraria from Eli Lilly Japan and a research grant from Asahi Kasei Pharma. I. Matsumoto has received speaker honoraria from Asahi Kasei Pharma, Bristol Myers Squibb, Chugai Pharmaceutical, Pfizer, Eli Lilly Japan, Eisai, Boehringer Ingelheim Japan, Astellas Pharma, UCB Japan, and GlaxoSmithKline. T. Ito-Ihara has received speaker honoraria from Teijin Pharma and travel support from Kissei Pharmaceutical. S. Hirata has received speaker\u2019s fees, consultancy fees, or research grants from AbbVie, Asahi-Kasei Pharma, Astellas Pharma, AstraZeneca, Ayumi Pharmaceutical, Bristol Myers Squibb, Boehringer Ingelheim, Chugai Pharmaceutical, Daiichi-Sankyo, Eisai, Eli Lilly Japan, Gilead Sciences, GlaxoSmithKline, Janssen Pharmaceutical, Nihon-Shinyaku, Novartis, Otsuka Pharmaceutical, Pfizer, Taisho Pharmaceutical, Mitsubishi Tanabe Pharma, and UCB Japan. The remaining authors declare no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval was granted by the Ethics Committee for Epidemiological Research at Hiroshima University on June 2, 2021 (approval number: E-2021\u20132465) and by the Institutional Review Board or Ethics Committee of each participating institution. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent from patients whose information was used was obtained via an opt-out form on a website, and those who did not consent were excluded from the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}],"article-number":"272"}}