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

Robson, Joanna; Doll, Helen; Suppiah, Ravi; Flossmann, Oliver; Harper, Lorraine; Hoglund, Peter; Jayne, David; Mahr, Alfred; Westman, Kerstin LU and Luqmani, Raashid (2015) In Annals of the Rheumatic Diseases 74(1). p.177-184
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of the Rheumatic Diseases
volume
74
issue
1
pages
177 - 184
publisher
British Medical Association
external identifiers
  • wos:000345945700037
  • scopus:84918575913
ISSN
1468-2060
DOI
10.1136/annrheumdis-2013-203927
language
English
LU publication?
yes
id
d4a4d641-f5c8-4122-81dd-0bd455b0bfda (old id 4962568)
date added to LUP
2015-02-03 07:04:24
date last changed
2017-11-12 03:34:57
@article{d4a4d641-f5c8-4122-81dd-0bd455b0bfda,
  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 &gt;= 1 item of damage and 32 (5.1%) &gt;= 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 &gt;= 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&lt;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 &gt;= 5 items of damage at a mean of 7 years postdiagnosis.},
  author       = {Robson, Joanna and Doll, Helen and Suppiah, Ravi and Flossmann, Oliver and Harper, Lorraine and Hoglund, Peter and Jayne, David and Mahr, Alfred and Westman, Kerstin and Luqmani, Raashid},
  issn         = {1468-2060},
  language     = {eng},
  number       = {1},
  pages        = {177--184},
  publisher    = {British Medical Association},
  series       = {Annals of the Rheumatic Diseases},
  title        = {Damage in the anca-associated vasculitides: long-term data from the European Vasculitis Study group (EUVAS) therapeutic trials},
  url          = {http://dx.doi.org/10.1136/annrheumdis-2013-203927},
  volume       = {74},
  year         = {2015},
}