Damage in the anca-associated vasculitides: long-term data from the European vasculitis study group (EUVAS) therapeutic trials

Research output: Contribution to journalArticle

Authors

  • Joanna Robson
  • Helen Doll
  • Ravi Suppiah
  • Oliver Flossmann
  • Peter Höglund
  • David Jayne
  • Alfred Mahr
  • Kerstin Westman
  • Raashid Luqmani

Colleges, School and Institutes

Abstract

OBJECTIVES: To describe short-term (up to 12 months) and long-term (up to 7 years) damage in patients with newly diagnosed antineutrophil-cytoplasm antibody-associated vasculitis (AAV).

METHODS: Data were combined from six European Vasculitis Study group trials (n=735). Long-term follow-up (LTFU) data available for patients from four trials (n=535). Damage accrued was quantified by the Vasculitis Damage Index (VDI). Sixteen damage items were defined a priori as being potentially treatment-related.

RESULTS: VDI data were available for 629 of 735 patients (85.6%) at baseline, at which time 217/629 (34.5%) had ≥1 item of damage and 32 (5.1%) ≥5 items, reflecting disease manifestations prior to diagnosis and trial enrolment. LTFU data were available for 467/535 (87.3%) at a mean of 7.3 years postdiagnosis. 302/535 patients (56.4%) had VDI data at LTFU, with 104/302 (34.4%) having ≥5 items and only 24 (7.9%) no items of damage. At 6 months and LTFU, the most frequent items were proteinuria, impaired glomerular filtration rate, hypertension, nasal crusting, hearing loss and peripheral neuropathy. The frequency of damage, including potentially treatment-related damage, rose over time (p<0.01). At LTFU, the most commonly reported items of treatment-related damage were hypertension (41.5%; 95% CI 35.6 to 47.4%), osteoporosis (14.1%; 9.9 to 18.2%), malignancy (12.6%; 8.6 to 16.6%), and diabetes (10.4%; 6.7 to 14.0%).

CONCLUSIONS: In AAV, renal, otolaryngological and treatment-related (cardiovascular, disease, diabetes, osteoporosis and malignancy) damage increases over time, with around one-third of patients having ≥5 items of damage at a mean of 7 years postdiagnosis.

Bibliographic note

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Details

Original languageEnglish
Pages (from-to)177-84
Number of pages8
JournalAnnals of the Rheumatic Diseases
Volume74
Issue number1
Publication statusPublished - Jan 2015

Keywords

  • Adult, Aged, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, Diabetes Mellitus, Disease Progression, Europe, Female, Glomerular Filtration Rate, Granulomatosis with Polyangiitis, Hearing Loss, Humans, Hypertension, Immunosuppressive Agents, Male, Microscopic Polyangiitis, Middle Aged, Nasal Obstruction, Neoplasms, Osteoporosis, Peripheral Nervous System Diseases, Proteinuria, Severity of Illness Index