Association between age at disease onset of anti-neutrophil cytoplasmic antibody–associated vasculitis and clinical presentation and short-term outcomes

Medientyp: E-Artikel
Titel: Association between age at disease onset of anti-neutrophil cytoplasmic antibody–associated vasculitis and clinical presentation and short-term outcomes
Beteiligte: Monti, Sara; Craven, Anthea; Klersy, Catherine; Montecucco, Carlomaurizio; Caporali, Roberto; Watts, Richard; Merkel, Peter A; Luqmani, Raashid; Achilleos, Katerina; Adler, Matthew; Alba, Marco A; Alba, Marco A; Albert, Daniel A; Alibaz-Oner, Fatma; Allcoat, Paul; Amano, Koichi; Amarasuriya, Manishka; Amudala, Naomi A; Andrews, Jacqueline; Archer, Amy M; Arimura, Yoshihiro; Atukorala, Inoshi; Azevedo, Elsa; Bajad, Shruti; [...]
Erschienen: Oxford University Press (OUP), 2021
Erschienen in: Rheumatology
Sprache: Englisch
DOI: 10.1093/rheumatology/keaa215
ISSN: 1462-0332; 1462-0324
Schlagwörter: Pharmacology (medical) ; Rheumatology
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Beschreibung: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Objectives</jats:title> <jats:p>ANCA-associated vasculitis (AAV) can affect all age groups. We aimed to show that differences in disease presentation and 6 month outcome between younger- and older-onset patients are still incompletely understood.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>We included patients enrolled in the Diagnostic and Classification Criteria for Primary Systemic Vasculitis (DCVAS) study between October 2010 and January 2017 with a diagnosis of AAV. We divided the population according to age at diagnosis: &lt;65 years or ≥65 years. We adjusted associations for the type of AAV and the type of ANCA (anti-MPO, anti-PR3 or negative).</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>A total of 1338 patients with AAV were included: 66% had disease onset at &lt;65 years of age [female 50%; mean age 48.4 years (s.d. 12.6)] and 34% had disease onset at ≥65 years [female 54%; mean age 73.6 years (s.d. 6)]. ANCA (MPO) positivity was more frequent in the older group (48% vs 27%; P = 0.001). Younger patients had higher rates of musculoskeletal, cutaneous and ENT manifestations compared with older patients. Systemic, neurologic,cardiovascular involvement and worsening renal function were more frequent in the older-onset group. Damage accrual, measured with the Vasculitis Damage Index (VDI), was significantly higher in older patients, 12% of whom had a 6 month VDI ≥5, compared with 7% of younger patients (P = 0.01). Older age was an independent risk factor for early death within 6 months from diagnosis [hazard ratio 2.06 (95% CI 1.07, 3.97); P = 0.03].</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Within 6 months of diagnosis of AAV, patients &gt;65 years of age display a different pattern of organ involvement and an increased risk of significant damage and mortality compared with younger patients.</jats:p> </jats:sec>
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