Τίτλος:
A past medical history of autoimmune disease predicts a future with fewer relapses in patients with ANCA-associated vasculitis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objective To explore the frequency and impact of an autoimmune disease past-medical history (PMH) in the clinical picture and outcomes of patients with antineutrophil cytoplasmic autoantibodies (ANCA) associated vasculitis (AAV). Methods This was a retrospective study of patients with biopsy-proven AAV, >16 years old, with detailed information about their PMH. Outcomes of interest included remission, treatment resistance, relapse, end-stage kidney disease (ESKD), and death. Results 206 patients with biopsy-proven AAV and available information regarding their PMH were studied. 63(30.6%) of them had a history of autoimmune disease prior to AAV diagnosis. The mean age overall was 54.1 years. One hundred and five patients (51%) were positive for PR3-ANCA, 101 (49%) for MPO-ANCA. Granulomatosis with polyangiitis was diagnosed in 79 (38.3%), microscopic polyangiitis in 97 (47.1%) and renal-limited vasculitis in 30 (14.6%) individuals. Remission rate was similar among patients with and without a PMH of autoimmune disease. Time-to-event analysis indicated that the relapse-free survival was significantly longer in patients with PMH of autoimmune disease (148.2 vs. 61.9 months, p-value <0.001). After adjusting for covariates, autoimmune disease history was associated with significantly lower risk of relapse (HR: 0.33, 95% CI: 0.15-0.72), which remained significant in males, patients ≥60 years old and those with C/PR3-ANCA, kidney and lung involvement. Conclusion Patients with a PMH of autoimmune disease, prior to AAV diagnosis, experienced significantly fewer relapses after achievement of remission, compared to patients without such a history, underlining the importance of individualisation of maintenance immunosuppressive therapy, given the different aetiopathogenetic settings the disease was developed. © Copyright Clinical and Experimental Rheumatology 2022.
Συγγραφείς:
Lionaki, S.
Marinaki, S.
Fragkioudaki, S.
Bellos, I.
Kalaitzakis, E.
Kalogeropoulos, P.
Liapis, G.
Tzioufas, A.G.
Boletis, J.N.
Περιοδικό:
Clinical and Experimental Rheumatology
Εκδότης:
Clinical and Experimental Rheumatology S.A.S.
Λέξεις-κλειδιά:
myeloblastin; neutrophil cytoplasmic antibody; peroxidase, adolescent; ANCA associated vasculitis; female; human; kidney disease; male; middle aged; recurrent disease; retrospective study; Wegener granulomatosis, Adolescent; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis; Antibodies, Antineutrophil Cytoplasmic; Female; Granulomatosis with Polyangiitis; Humans; Kidney Diseases; Male; Middle Aged; Myeloblastin; Peroxidase; Recurrence; Retrospective Studies
DOI:
10.55563/clinexprheumatol/acphbb
