In contrast, disease manifestations did not differ between MPO-ANCA+ and PR3-ANCA+ GPA patients who had been enrolled in two large clinical trials (41) and studied in a post-hoc analysis by Miloslavsky et al. These conflicting results with regard to disease manifestations may be related to differences in study design (clinical trial vs. single center cohort study) (48), classification of GPA and MPA, and enrollment criteria. This evidence concerns the gene MPO and granulomatosis with polyangiitis.