Treatment and its side effects in ANCA-associated vasculitides - Study based on POLVAS registry data.


Journal

Advances in medical sciences
ISSN: 1898-4002
Titre abrégé: Adv Med Sci
Pays: Netherlands
ID NLM: 101276222

Informations de publication

Date de publication:
Mar 2020
Historique:
received: 01 02 2019
revised: 08 09 2019
accepted: 03 01 2020
pubmed: 21 1 2020
medline: 3 2 2021
entrez: 21 1 2020
Statut: ppublish

Résumé

The aim of this study is to present the treatment modalities and associated side effects in a Polish nation-wide ANCA-associated vasculitides (AAV) patients' cohort. Retrospective analysis of patients diagnosed with AAV between 1990 and 2016, included in the POLVAS registry was performed. Standard descriptive statistic methods were used with an emphasis on the treatment modalities. There were 625 patients diagnosed with AAV included in this study: 417 cases of granulomatosis with polyangiitis (GPA; 66.7%), 106 cases of microscopic polyangiitis (MPA; 17.0%) and 102 cases of eosinophilic granulomatosis with polyangiitis (EGPA; 16.3%). The mean age at the date of diagnosis was 50.4 (±15.7) years and the median observational period amounted to 4.0 (2.0-8.0) years. Glucocorticosteroids (GCs) were the medicaments most frequently used for remission induction (593/622; 95.3%), followed by cyclophosphamide (487/622; 78.3%), rituximab (44/622; 7.1%), and methotrexate (39/622; 6.3%). GCs were also most frequently administered for maintenance therapy (499/592; 84.3%), followed by azathioprine (224/592; 37.8%), methotrexate (136/592; 23.0%) and mycophenolate mofetil (99/592; 16.7%). The median cumulative doses of cyclophosphamide and rituximab equalled 7.99 g (4.18-14.0) and 2000 mg (1500-2800), respectively. The most commonly observed adverse events included: infections - 214/551 cases (38.8%), which were associated with the time of observation (OR = 1.05; 95% CI 1.01-1.10), the use of GCs intravenous pulses (OR = 2.76; 95% CI 1.68-4.54) and need for haemodialysis (OR = 1.73; 95% CI 1.10-2.71). Polish patients with AAV were predominantly treated according to appropriate guidelines. The most frequent adverse events were typical for usually administered immunosuppressive treatment.

Identifiants

pubmed: 31958704
pii: S1896-1126(20)30002-X
doi: 10.1016/j.advms.2020.01.002
pii:
doi:

Substances chimiques

Glucocorticoids 0
Immunosuppressive Agents 0
Rituximab 4F4X42SYQ6
Cyclophosphamide 8N3DW7272P
Azathioprine MRK240IY2L
Methotrexate YL5FZ2Y5U1

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

156-162

Informations de copyright

Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare no conflict of interests.

Auteurs

Grzegorz Biedroń (G)

2nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland.

Anna Włudarczyk (A)

2nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland.

Katarzyna Wawrzycka-Adamczyk (K)

2nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland.

Krzysztof Wójcik (K)

2nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland.

Jan Sznajd (J)

Department of Rheumatology, Raigmore Hospital, Inverness, UK; Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.

Zbigniew Zdrojewski (Z)

Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland.

Anna Masiak (A)

Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland.

Zenobia Czuszyńska (Z)

Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland.

Maria Majdan (M)

Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Lublin, Poland.

Radosław Jeleniewicz (R)

Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Lublin, Poland.

Marian Klinger (M)

Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland; Department of Nephrology, Institute of Medicine University of Opole, Opole University Hospital, Opole, Poland.

Katarzyna Jakuszko (K)

Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.

Olumide Olatubosun Rowaiye (OO)

Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.

Marek Brzosko (M)

Department of Rheumatology and Internal Diseases, Pomeranian Medical University in Szczecin, Szczecin, Poland.

Iwona Brzosko (I)

Department of Rheumatology and Internal Diseases, Pomeranian Medical University in Szczecin, Szczecin, Poland.

Alicja Dębska-Ślizień (A)

Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdansk, Gdansk, Poland.

Hanna Storoniak (H)

Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdansk, Gdansk, Poland.

Witold Tłustochowicz (W)

Department of Internal Medicine and Rheumatology, Military Medical Institute, Warszawa, Poland.

Joanna Kur-Zalewska (J)

Department of Internal Medicine and Rheumatology, Military Medical Institute, Warszawa, Poland.

Małgorzata Wisłowska (M)

Department of Internal Diseases and Rheumatology, Central Clinical Hospital of the Ministry of the Interior and Administration, Warszawa, Poland.

Marta Madej (M)

Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Wroclaw, Poland.

Anna Hawrot-Kawecka (A)

Department of Internal Medicine and Metabolic Diseases, Medical University of Silesia, Katowice, Poland.

Piotr Głuszko (P)

Department of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warszawa, Poland.

Eugeniusz J Kucharz (EJ)

Department of Internal Medicine, Rheumatology and Clinical Immunology, Medical University of Silesia, Katowice, Poland.

Jacek Musiał (J)

2nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland.

Wojciech Szczeklik (W)

2nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland. Electronic address: wojciech.szczeklik@uj.edu.pl.

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Classifications MeSH