Articles producció científica> Medicina i Cirurgia

Clinical characteristics and outcome of Spanish patients with ANCA-associated vasculitides Impact of the vasculitis type, ANCA specificity, and treatment on mortality and morbidity

  • Identification data

    Identifier: imarina:9351774
  • Authors:

    Solans-Laqué, R
    Fraile, G
    Rodriguez-Carballeira, M
    Caminal, L
    Castillo, MJ
    Martínez-Valle, F
    Sáez, L
    Rios, JJ
    Solanich, X
    Oristrell, J
    Pasquau, F
    Fonseca, E
    Zamora, M
    Callejas, JL
    Frutos, B
    Abdilla, M
    Fanlo, P
    García-Sánchez, I
    López-Dupla, M
    Sopeña, B
    Pérez-Iglesias, A
    Bosch, JA
    Medicine
    10.1097/MD.0000000000006083
    Medicine. 96 (8):
  • Others:

    Author, as appears in the article.: Solans-Laqué, R; Fraile, G; Rodriguez-Carballeira, M; Caminal, L; Castillo, MJ; Martínez-Valle, F; Sáez, L; Rios, JJ; Solanich, X; Oristrell, J; Pasquau, F; Fonseca, E; Zamora, M; Callejas, JL; Frutos, B; Abdilla, M; Fanlo, P; García-Sánchez, I; López-Dupla, M; Sopeña, B; Pérez-Iglesias, A; Bosch, JA
    Department: Medicina i Cirurgia
    URV's Author/s: López Dupla, Jesús Miguel
    Keywords: Term-follow-up Systemic wegeners-granulomatosis Spanish people Small-vessel vasculitis Randomized-trial Prognostic-factors Polyarteritis-nodosa Outcome Mortality predictors Microscopic polyangiitis Infections Granulomatosis with polyangiitis Eosinophilic granulomatosis with polyangiitis Churg-strauss-syndrome Chinese patients Antibody-associated vasculitis Anca-associated vasculitides
    Abstract: The aim of this study was to describe the clinical characteristics of ANCA-associated vasculitides (AAV) at presentation, in a wide cohort of Spanish patients, and to analyze the impact of the vasculitis type, ANCA specificity, prognostic factors, and treatments administered at diagnosis, in the outcome.A total of 450 patients diagnosed between January 1990 and January 2014 in 20 Hospitals from Spain were included. Altogether, 40.9% had granulomatosis with polyangiitis (GPA), 37.1% microscopic polyangiitis (MPA), and 22% eosinophilic granulomatosis with polyangiitis (EGPA). The mean age at diagnosis was 55.6 +/- 17.3 years, patients with MPA being significantly older (P < 0.001). Fever, arthralgia, weight loss, respiratory, and ear-nose-throat (ENT) symptoms, were the most common at disease onset. ANCAs tested positive in 86.4% of cases: 36.2% C-ANCA-PR3 and 50.2% P-ANCA-MPO. P-ANCA-MPO was significantly associated with an increased risk for renal disease (OR 2.6, P < 0.001) and alveolar hemorrhage (OR 2, P = 0.010), while C-ANCA-PR3 was significantly associated with an increased risk for ENT (OR 3.4, P < 0.001) and ocular involvement (OR 2.3, P = 0.002). All patients received corticosteroids (CS) and 74.9% cyclophosphamide (CYC). The median follow-up was 82 months (IQR 100.4). Over this period 39.9% of patients suffered bacterial infections and 14.6% opportunistic infections, both being most prevalent in patients with high-cumulated doses of CYC and CS (P < 0.001). Relapses were recorded in 36.4% of cases with a mean rate of 2.5 +/- 2.3, and were more frequent in patients with C-ANCA-PR3 (P = 0.012). The initial disease severity was significantly associated with mortality but not with the occurrence of relapses. One hundred twenty-nine (28.7%) patients (74 MPA, 41 GPA, 14 EGPA) died. The mean survival was 58 months (IQR 105) and was significantly lower for patients with MPA (P < 0.001). Factors independently related to death were renal involvement (P = 0.010), cardiac failure (P = 0.029) and age over 65 years old (P < 0.001) at disease onset, and bacterial infections (P < 0.001). An improved outcome with significant decrease in mortality and treatment-related morbidity was observed in patients diagnosed after 2000, and was related to the implementation of less toxic regimens adapted to the disease activity and stage, and a drastic reduction in the cumulated CYC and CS dose.
    Thematic Areas: Saúde coletiva Odontología Nutrição Medicine, general & internal Medicine (miscellaneous) Medicine (all) Medicina iii Medicina ii Medicina i Matemática / probabilidade e estatística Interdisciplinar Geografía General medicine Farmacia Ensino Engenharias iv Enfermagem Educação física Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Biotecnología Astronomia / física Antropologia / arqueologia
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: jesusmiguel.lopez@urv.cat
    Author identifier: 0000-0002-9141-2523
    Record's date: 2024-07-20
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://journals.lww.com/md-journal/fulltext/2017/02240/clinical_characteristics_and_outcome_of_spanish.9.aspx
    Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Medicine. 96 (8):
    APA: Solans-Laqué, R; Fraile, G; Rodriguez-Carballeira, M; Caminal, L; Castillo, MJ; Martínez-Valle, F; Sáez, L; Rios, JJ; Solanich, X; Oristrell, J; Pasqu (2017). Clinical characteristics and outcome of Spanish patients with ANCA-associated vasculitides Impact of the vasculitis type, ANCA specificity, and treatment on mortality and morbidity. Medicine, 96(8), -. DOI: 10.1097/MD.0000000000006083
    Article's DOI: 10.1097/MD.0000000000006083
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2017
    Publication Type: Journal Publications
  • Keywords:

    Medicine (Miscellaneous),Medicine, General & Internal
    Term-follow-up
    Systemic wegeners-granulomatosis
    Spanish people
    Small-vessel vasculitis
    Randomized-trial
    Prognostic-factors
    Polyarteritis-nodosa
    Outcome
    Mortality predictors
    Microscopic polyangiitis
    Infections
    Granulomatosis with polyangiitis
    Eosinophilic granulomatosis with polyangiitis
    Churg-strauss-syndrome
    Chinese patients
    Antibody-associated vasculitis
    Anca-associated vasculitides
    Saúde coletiva
    Odontología
    Nutrição
    Medicine, general & internal
    Medicine (miscellaneous)
    Medicine (all)
    Medicina iii
    Medicina ii
    Medicina i
    Matemática / probabilidade e estatística
    Interdisciplinar
    Geografía
    General medicine
    Farmacia
    Ensino
    Engenharias iv
    Enfermagem
    Educação física
    Ciências biológicas iii
    Ciências biológicas ii
    Ciências biológicas i
    Biotecnología
    Astronomia / física
    Antropologia / arqueologia
  • Documents:

  • Cerca a google

    Search to google scholar