Abstract：
BACKGROUND: There may be some diversity in the practice of co-prescribing 2-mercaptoethane sodium sulfonate (mesna) with cyclophosphamide (CYC) for ANCA-associated vasculitis (AAV).
OBJECTIVE: To assess the practice of prescribing mesna prophylaxis for CYC-treated patients with AAV.
METHODS: We invited authors of publications on AAV referenced in MEDLINE over the previous 10 years to participate in an anonymous online survey. Respondents were eligible if they were involved in CYC treatments for AAV. The survey asked about the characteristics of the respondents and their practice in using CYC and mesna to treat AAV and the underlying rationale. We compared 18 variables between mesna prescribers and their counterparts to identify factors associated with mesna use.
RESULTS: In total, 139 eligible individuals completed the survey. The participants were from 34 countries and were essentially physicians (98%). Overall, 68%, 19% and 13% of respondents prescribed mesna systematically, never, or on a selective basis. As compared with never/selective-prescribers, systematic-prescribers were more often ≤ 39 years old (P = 0.008), more often used intermittent pulse therapy as the exclusive/predominant CYC administration scheme (P < 0.001), were more frequently based in France/Germany/Italy than in England/United States (P < 0.001), and more often indicated adherence to local standards (P = 0.003) or (inter)national guidelines for AAV (P < 0.001) as a rationale for their mesna practice. Never/selective-prescribers more commonly reported that their mesna prescription pattern had changed as compared with their former practice (P < 0.001).
CONCLUSIONS: Systematic co-prescription of mesna is the prevailing practice for CYC treatments for AAV. The practice seems to involve practicability considerations and differs between generations.
OBJECTIVE: To assess the practice of prescribing mesna prophylaxis for CYC-treated patients with AAV.
METHODS: We invited authors of publications on AAV referenced in MEDLINE over the previous 10 years to participate in an anonymous online survey. Respondents were eligible if they were involved in CYC treatments for AAV. The survey asked about the characteristics of the respondents and their practice in using CYC and mesna to treat AAV and the underlying rationale. We compared 18 variables between mesna prescribers and their counterparts to identify factors associated with mesna use.
RESULTS: In total, 139 eligible individuals completed the survey. The participants were from 34 countries and were essentially physicians (98%). Overall, 68%, 19% and 13% of respondents prescribed mesna systematically, never, or on a selective basis. As compared with never/selective-prescribers, systematic-prescribers were more often ≤ 39 years old (P = 0.008), more often used intermittent pulse therapy as the exclusive/predominant CYC administration scheme (P < 0.001), were more frequently based in France/Germany/Italy than in England/United States (P < 0.001), and more often indicated adherence to local standards (P = 0.003) or (inter)national guidelines for AAV (P < 0.001) as a rationale for their mesna practice. Never/selective-prescribers more commonly reported that their mesna prescription pattern had changed as compared with their former practice (P < 0.001).
CONCLUSIONS: Systematic co-prescription of mesna is the prevailing practice for CYC treatments for AAV. The practice seems to involve practicability considerations and differs between generations.
摘要：
背景：联合使用2-巯基乙烷磺酸钠（mesna）和环磷酰胺（CYC）治疗ANCA相关性血管炎（AAV）的实践可能存在一些差异。
目的：评估CYC治疗的AAV患者处方mesna预防的实践。
方法：我们邀请了MEDLINE在过去10年中引用的AAV出版物的作者参加匿名在线调查。如果受访者参与了AAV的CYC治疗，他们就有资格。调查询问了受访者的特征以及他们使用CYC和mesna治疗AAV的做法以及基本原理。我们比较了mesna处方者及其对应者之间的18个变量，以确定与mesna使用相关的因素。
结果：总计，139名符合条件的个人完成了调查。参与者来自34个国家，基本上是医生（98％）。总的来说,68%,19%和13%的受访者系统地处方mesna，从来没有，或者在选择性的基础上。与从不/选择性处方者相比，系统处方者通常≤39岁(P=0.008)，更经常使用间歇脉冲治疗作为专有/主要CYC给药方案（P<0.001），在法国/德国/意大利的频率高于英国/美国(P<0.001)，并且更经常表明遵守当地标准（P=0.003）或（国际）AAV指南（P<0.001）作为其mesna实践的理由。与以前的实践相比，从未/选择性处方者更常报告其mesna处方模式发生了变化（P<0.001）。
结论：Mesna的系统共同处方是CYC治疗AAV的普遍做法。这种做法似乎涉及实用性考虑，并且各代人之间有所不同。
目的：评估CYC治疗的AAV患者处方mesna预防的实践。
方法：我们邀请了MEDLINE在过去10年中引用的AAV出版物的作者参加匿名在线调查。如果受访者参与了AAV的CYC治疗，他们就有资格。调查询问了受访者的特征以及他们使用CYC和mesna治疗AAV的做法以及基本原理。我们比较了mesna处方者及其对应者之间的18个变量，以确定与mesna使用相关的因素。
结果：总计，139名符合条件的个人完成了调查。参与者来自34个国家，基本上是医生（98％）。总的来说,68%,19%和13%的受访者系统地处方mesna，从来没有，或者在选择性的基础上。与从不/选择性处方者相比，系统处方者通常≤39岁(P=0.008)，更经常使用间歇脉冲治疗作为专有/主要CYC给药方案（P<0.001），在法国/德国/意大利的频率高于英国/美国(P<0.001)，并且更经常表明遵守当地标准（P=0.003）或（国际）AAV指南（P<0.001）作为其mesna实践的理由。与以前的实践相比，从未/选择性处方者更常报告其mesna处方模式发生了变化（P<0.001）。
结论：Mesna的系统共同处方是CYC治疗AAV的普遍做法。这种做法似乎涉及实用性考虑，并且各代人之间有所不同。
