The Association Between Age at Diagnosis and Disease Characteristics and Damage in Patients With ANCA-Associated Vasculitis.
Journal
Arthritis & rheumatology (Hoboken, N.J.)
ISSN: 2326-5205
Titre abrégé: Arthritis Rheumatol
Pays: United States
ID NLM: 101623795
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
revised:
07
06
2023
received:
01
04
2023
accepted:
06
07
2023
medline:
30
11
2023
pubmed:
11
7
2023
entrez:
11
7
2023
Statut:
ppublish
Résumé
This study examined the relationship between age at diagnosis and disease characteristics and damage in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Analysis of a prospective longitudinal cohort of patients with granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic GPA (EGPA) in the Vasculitis Clinical Research Consortium (2013-2021). Disease cohorts were divided by age at diagnosis (years): children (<18), young adults (18-40), middle-aged adults (41-65), and older adults (>65). Data included demographics, ANCA type, clinical characteristics, Vasculitis Damage Index (VDI) scores, ANCA Vasculitis Index of Damage (AVID) scores, and novel disease-specific and non-disease-specific damage scores built from VDI and AVID items. Analysis included data from 1020 patients with GPA/MPA and 357 with EGPA. Female predominance in GPA/MPA decreased with age at diagnosis. AAV in childhood was more often GPA and proteinase 3-ANCA positive. Children with GPA/MPA experienced more subglottic stenosis and alveolar hemorrhage; children and young adults with EGPA experienced more alveolar hemorrhage, need for intubation, and gastrointestinal involvement. Older adults (GPA/MPA) had more neurologic manifestations. After adjusting for disease duration, medications, tobacco, and ANCA, all damage scores increased with age at diagnosis for GPA/MPA (P < 0.001) except the disease-specific damage score, which did not differ (P = 0.44). For EGPA, VDI scores increased with age at diagnosis (P < 0.009), whereas all other scores were not significantly different. Age at diagnosis is associated with clinical characteristics in AAV. Although VDI and AVID scores increase with age at diagnosis, this is driven by non-disease-specific damage items.
Substances chimiques
Antibodies, Antineutrophil Cytoplasmic
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2216-2227Subventions
Organisme : NCATS NIH HHS
Pays : United States
Organisme : NCRR NIH HHS
ID : U54-RR-019497
Pays : United States
Organisme : NIAMS NIH HHS
ID : U54-AR-057319
Pays : United States
Organisme : NCATS NIH HHS
Pays : United States
Organisme : NCRR NIH HHS
ID : U54-RR-019497
Pays : United States
Organisme : NIAMS NIH HHS
ID : U54-AR-057319
Pays : United States
Informations de copyright
© 2023 American College of Rheumatology.
Références
Jennette J. Overview of the 2012 revised International Chapel Hill Consensus Conference nomenclature of vasculitides. Clin Exp Nephrol 2013;17:603-6.
Jariwala MP, Laxer RM. Primary vasculitis in childhood: GPA and MPA in childhood [review]. Front Pediatr 2018;6:226.
Cabral DA, Canter DL, Muscal E, et al. Comparing presenting clinical features in 48 children with microscopic polyangiitis to 183 children who have granulomatosis with polyangiitis (Wegener's): an ARChiVe Cohort study. Arthritis Rheumatol 2016;68:2514-26.
Cabral DA, Uribe AR, Benseler S, et al; the ARChiVe Investigators Network. Classification, presentation, and initial treatment of Wegener's granulomatosis in childhood. Arthritis Rheum 2009;60:3413-24.
Redondo-Rodriguez R, Mena-Vázquez N, Cabezas-Lucena AM, et al. Systematic review and metaanalysis of worldwide incidence and prevalence of antineutrophil cytoplasmic antibody (ANCA) associated vasculitis [review]. J Clin Med 2022;11:2573.
Ambrose N, Morgan T, Galloway J, et al; UK JSLE Study Group. Differences in disease phenotype and severity in SLE across age groups. Lupus 2016;25:1542-50.
Iudici M, Pagnoux C, Quartier P, et al. Childhood- versus adult-onset ANCA-associated vasculitides: a nested, matched case-control study from the French Vasculitis Study Group Registry [review]. Autoimmun Rev 2018;17:108-14.
Seo P, Luqmani RA, Flossman O, et al. The future of damage assessment in vasculitis. J Rheumatol 2007;34:1357-71.
Mohammad AJ, Bakoush O, Sturfelt G, et al. The extent and pattern of organ damage in small vessel vasculitis measured by the Vasculitis Damage Index (VDI). Scand J Rheumatol 2009;38:268-75.
Monti S, Craven A, Klersy C, et al; DCVAS Collaborators. Association between age at disease onset of anti-neutrophil cytoplasmic antibody-associated vasculitis and clinical presentation and short-term outcomes. Rheumatology (Oxford) 2021;60:617-28.
Exley AR, Bacon PA, Luqmani RA, et al. Development and initial validation of the Vasculitis Damage Index for the standardized clinical assessment of damage in the systemic vasculitides. Arthritis Rheum 1997;40:371-80.
Merkel PA, Aydin SZ, Boers M, et al. The OMERACT core set of outcome measures for use in clinical trials of ANCA-associated vasculitis. J Rheumatol 2011;38:1480-6.
Rottem M, Fauci AS, Hallahan CW, et al. Wegener granulomatosis in children and adolescents: clinical presentation and outcome. J Pediatr 1993;122:26-31.
Westwell-Roper C, Lubieniecka JM, Brown KL, et al; ARChiVe Investigators Network within the PedVas initiative. Clinical practice variation and need for pediatric-specific treatment guidelines among rheumatologists caring for children with ANCA-associated vasculitis: an international clinician survey. Pediatr Rheumatol Online J 2017;15:61.
James KE, Xiao R, Merkel PA, Weiss PF. Variation in the treatment of children hospitalized with antineutrophil cytoplasmic antibody-associated vasculitis in the US. Arthritis Care Res (Hoboken) 2017;69:1377-83.
Brogan P, Yeung RS, Cleary G, et al; the PePRS Study Group. Phase IIa global study evaluating rituximab for the treatment of pediatric patients with granulomatosis with polyangiitis or microscopic polyangiitis. Arthritis Rheumatol 2022;74:124-33.
Thietart S, Beinse G, Smets P, et al; the French Vasculitis Study Group. Patients of 75 years and over with ANCA-associated vasculitis have a lower relapse risk than younger patients: a multicentre cohort study. J Intern Med 2022;291:350-63.
Flossmann O, Bacon P, de Groot K, et al. Development of comprehensive disease assessment in systemic vasculitis [review]. Ann Rheum Dis 2007;66:283-92.