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Thyroid disease in ANCA-associated vasculitis : a clinical and epidemiological study

Wilding, Anna LU orcid ; Smith, Rona ; Jayne, David ; Segelmark, Mårten LU and Mohammad, Aladdin J. LU (2024) In RMD Open 10(2).
Abstract

Objectives To describe clinical and laboratory characteristics and outcomes in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and thyroid disease (TD). We also aimed to calculate incidence and identify predictors of TD in two large cohorts of patients with AAV. Methods The study comprised 644 patients with AAV in a population-based cohort from southern Sweden (n=325) and a cohort from a specialised vasculitis centre in Cambridge, UK (n=319). Diagnosis and classification of AAV and TD were confirmed by medical record review. Person-years (PY) of follow-up were calculated from AAV diagnosis to the earliest of TD, death or the end of study. Cox-regression analysis was employed to study predictors of... (More)

Objectives To describe clinical and laboratory characteristics and outcomes in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and thyroid disease (TD). We also aimed to calculate incidence and identify predictors of TD in two large cohorts of patients with AAV. Methods The study comprised 644 patients with AAV in a population-based cohort from southern Sweden (n=325) and a cohort from a specialised vasculitis centre in Cambridge, UK (n=319). Diagnosis and classification of AAV and TD were confirmed by medical record review. Person-years (PY) of follow-up were calculated from AAV diagnosis to the earliest of TD, death or the end of study. Cox-regression analysis was employed to study predictors of TD. Results At AAV diagnosis, 100 individuals (15.5%, 77 females) had TD, 59 had myeloperoxidase (MPO)ANCA+ and 34 had proteinase-3 (PR3)-ANCA+. Patients with TD tended to have lower C reactive protein, lower haemoglobin and fewer constitutional symptoms. Survival and renal survival was greater in those patients with AAV with pre-existing TD. During 4522 PY of follow-up, a further 29 subjects developed TD, yielding an incidence rate of 641/100 000 PY. No analysed factor predicted de novo TD in AAV. The prevalence of TD among patients with AAV in southern Sweden was 18%. Conclusion TD is a common comorbidity in AAV, affecting nearly one in five. While TD diagnosis is more common in females and MPO-ANCA+, these factors do not predict de novo TD after initiation of AAV treatment, necessitating monitoring of all patients with AAV with respect to this comorbidity.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
epidemiology, incidence, prevalence, vasculitis
in
RMD Open
volume
10
issue
2
article number
e003996
publisher
BMJ Publishing Group
external identifiers
  • scopus:85191917443
  • pmid:38688691
ISSN
2056-5933
DOI
10.1136/rmdopen-2023-003996
language
English
LU publication?
yes
id
39155b1e-a44f-4aad-a646-2e8ffcc7acba
date added to LUP
2024-05-16 12:39:10
date last changed
2024-06-13 15:25:24
@article{39155b1e-a44f-4aad-a646-2e8ffcc7acba,
  abstract     = {{<p>Objectives To describe clinical and laboratory characteristics and outcomes in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and thyroid disease (TD). We also aimed to calculate incidence and identify predictors of TD in two large cohorts of patients with AAV. Methods The study comprised 644 patients with AAV in a population-based cohort from southern Sweden (n=325) and a cohort from a specialised vasculitis centre in Cambridge, UK (n=319). Diagnosis and classification of AAV and TD were confirmed by medical record review. Person-years (PY) of follow-up were calculated from AAV diagnosis to the earliest of TD, death or the end of study. Cox-regression analysis was employed to study predictors of TD. Results At AAV diagnosis, 100 individuals (15.5%, 77 females) had TD, 59 had myeloperoxidase (MPO)ANCA+ and 34 had proteinase-3 (PR3)-ANCA+. Patients with TD tended to have lower C reactive protein, lower haemoglobin and fewer constitutional symptoms. Survival and renal survival was greater in those patients with AAV with pre-existing TD. During 4522 PY of follow-up, a further 29 subjects developed TD, yielding an incidence rate of 641/100 000 PY. No analysed factor predicted de novo TD in AAV. The prevalence of TD among patients with AAV in southern Sweden was 18%. Conclusion TD is a common comorbidity in AAV, affecting nearly one in five. While TD diagnosis is more common in females and MPO-ANCA+, these factors do not predict de novo TD after initiation of AAV treatment, necessitating monitoring of all patients with AAV with respect to this comorbidity.</p>}},
  author       = {{Wilding, Anna and Smith, Rona and Jayne, David and Segelmark, Mårten and Mohammad, Aladdin J.}},
  issn         = {{2056-5933}},
  keywords     = {{epidemiology; incidence; prevalence; vasculitis}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{2}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{RMD Open}},
  title        = {{Thyroid disease in ANCA-associated vasculitis : a clinical and epidemiological study}},
  url          = {{http://dx.doi.org/10.1136/rmdopen-2023-003996}},
  doi          = {{10.1136/rmdopen-2023-003996}},
  volume       = {{10}},
  year         = {{2024}},
}