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

Autores da FMUP

• Elsa Irene Peixoto Azevedo Silva

  Autor

Participantes de fora da FMUP

• Monti, S
• Klersy, C
• Montecucco, C
• Caporali, R
• Watts, R
• Luqmani, R
• Achilleos, K
• Adler, M
• Alba, MA
• Albert, DA
• Alibaz-Oner, F
• Allcoat, P
• Amano, K
• Amarasuriya, M
• Amudala, NA
• Andrews, J
• Archer, AM
• Arimura, Y
• Atukorala, I
• Bajad, S
• Baldwin, C
• Barra, LJ
• Baslund, B
• Basu, N
• Baykal, M
• Berger, C
• Berglin, E
• Besada, E
• Bhardwaj, M
• Bischof, A
• Blockmans, D
• Blood, J
• Draibe, JB
• Brand, S
• Brandao, M
• Bruce, IN
• Butler, A
• Calabrese, LH
• Ferrer, DC
• Carette, S
• Carmona, D
• Ceunen, H
• Chakravarty, K
• Chapman, PT
• Chocova, Z
• Chung, SA
• Ci, W
• Cid, MC
• Clark, TM
• Clarkson, MR
• de Jesus Contreras-Rodr?guez, F
• Conway, R
• Cooke, K
• Vir?s, XC
• Cordeiro, A
• Costa, A
• Craven, A
• Culfear, K
• Daikeler, T
• Danda, D
• Das, SK
• Dasgupta, B
• De Castro, AM
• Dehghan, N
• Devassy, R
• Dhindsa, N
• Diamantopoulos, AP
• Direskeneli, H
• Dobashi, H
• Juan, D
• Durrani, M
• Edelsten, C
• Eifert, J
• Elhayek, S
• Elsideeg, S
• Endo, T
• Erden, A
• Erer, B
• Eriksson, P
• Erturk, Z
• Esp?gol-Frigol?, G
• Felicetti, M
• Ferraro, A
• Ferro, JM
• Fifi-Mah, A
• Flores-Su?rez, LF
• Flossmann, O
• Flynn, D
• Fonseca, JE
• Foot, J
• Foote, M
• Forbess, L
• Fujimoto, S
• Fukuoka, K
• Furtado, C
• Furuta, S
• Gaffo, AL
• Gallagher, P
• Gao, N
• Gatenby, P
• Gendi, N
• Geraldes, R
• Gerits, A
• Gioffredi, A
• Gomples, L
• Gon?alves, MJ
• Gondo, P
• Graham, A
• Grainger, R
• Gray, DT
• Grayson, PC
• Griffiths, L
• Guo, Y
• Gupta, R
• Gylling, M
• Hajj-Ali, RA
• Hammam, N
• Harigai, M
• Hartley, L
• Haslett, J
• Hassan, A
• Hatemi, G
• Hellmich, B
• Henckaerts, L
• Henes, JC
• Hepburn, J
• Herd, V
• Hess, C
• Hill, C
• Hinojosa-Azaola, A
• Hirahashi, J
• Hirano, F
• Ho?evar, A
• Holle, J
• Hollinger, N
• Homma, S
• Howard, T
• Hoyles, RK
• Hruskova, Z
• Hutcheon, G
• Ignacak, M
• Igney-Oertel, A
• Ikeda, K
• Ikegaya, N
• Jagadeesh, S
• Jaquith, J
• Jayne, DRW
• Jewell, T
• Jones, C
• Joshi, A
• Kalyoncu, U
• Kamal?, S
• Kamath, S
• Lai, KS
• Kaname, S
• Kanchinadham, S
• Karada?, ?
• Karube, M
• Kaszuba, M
• Kaur, R
• Kawakami, T
• Kawashima, S
• Khalidi, N
• Khan, A
• Kikuchi, M
• Kilic, L
• Kimura, M
• King, MJ
• Klapa, S
• Klocke, R
• Kobayashi, T
• Kobayashi, S
• Komagata, Y
• Kronbichler, A
• Kuczia, P
• Kumar, MS
• Kurosawa, M
• Lamprecht, P
• Langford, CA
• Lanyon, P
• Laversuch, C
• Lee, SJ
• Leoni, S
• Li, J
• Liang, K
• Liang, P
• Liao, H
• Lee, LA
• Luqmani, RA
• Lyle, A
• MacDonald, M
• Mackie, SL
• Madden, L
• Magliano, M
• Makino, H
• Makol, A
• Malaiya, R
• Malaviya, A
• Manthri, R
• Maritati, F
• da Silva, AM
• Mason, JC
• Matara, C
• Matsui, K
• Matteson, EL
• McBride, D
• McCullough, K
• McGeoch, L
• McLaren, J
• McMillian, C
• Mendiratta, N
• Menon, A
• Merinopoulos, D
• Merkel, PA
• Merkel, P
• Messier, S
• Micheletti, RG
• Mills, K
• Milman, N
• Minoda, M
• Minz, RW
• M?ck, C
• Mohammad, AJ
• Moiseev, S
• Moitinho, M
• Molloy, E
• Monach, PA
• Montgomery, M
• Moosig, F
• Moradizadeh, M
• Morgan, M
• Morgan, AW
• Morgan, A
• Muir, A
• Mukhtyar, C
• M?ller, A
• Muratore, F
• Muso, E
• Nada, R
• Nakajima, H
• Nakajima, T
• Nakano, H
• Nandagudi, A
• Neumann, T
• Ng, YF
• Ng, KH
• Nogueira, EL
• Nolkha, N
• Nordstr?m, D
• Novikov, P
• Nugaliyadde, A
• O?Donnell, JL
• O?Donoghue, J
• O?Neill, L
• O?Riordan, E
• Oatley, M
• Okubo, K
• Oliva, E
• Oshikawa, H
• Ota, Y
• Padoan, R
• Pagnoux, C
• Pan, L
• Panaritis, K
• Park, JK
• Patel, S
• Patil, P
• Pazzola, G
• Peall, A
• Pearce, F
• Pehlevan, S
• Pereira, L
• Pettersson, T
• Pineau, CA
• Piril?, L
• Poglodek, B
• Ponte, C
• Prieto-Gonz?lez, S
• Priya, SR
• Purewal, B
• Purschke, S
• Putaala, J
• Quickert, S
• Quincey, V
• Raghuvanshi, S
• Rajasekhar, L
• Ranganathan, D
• Rathi, M
• Rees, D
• Rees, F
• Renken, U
• Restuccia, G
• Rhee, RL
• Rice, B
• Robins, D
• Robson, J
• Rodrigues, M
• Rom?o, VC
• Rotar, ?
• Ruediger, C
• Rutgers, A
• S?, AC
• Saavedra, MJ
• Sada, K
• Sahbudin, I
• Salvarani, C
• Sandhu, N
• Santos, E
• Sato, Y
• Sch?fer, VS
• Schiavon, F
• Schmidt, WA
• Segelmark, M
• Shahin, A
• Sharma, A
• Shotton, J
• Silva, C
• Singer, OG
• Sivasuthan, G
• Smolen, S
• Solanich-Moreno, X
• Boixader, LS
• Song, YW
• Springer, J
• Sreih, AG
• Srivastava, R
• Stamp, LK
• Stevens, R
• Strbian, D
• Sugino, K
• Sunderk?tter, C
• Suppiah, R
• Suzuki, K
• Szekanecz, Z
• Sznajd, J
• Taimen, K
• Tak, PP
• Takeuchi, T
• Takizawa, N
• Tames, L
• Tan, BE
• Tanaka, M
• Tang, MW
• Tatlisumak, T
• Tesar, V
• Thomas, A
• Tian, X
• Tokunaga, K
• Tombetti, E
• Tom?i?, M
• Toz, B
• Tsukamoto, T
• Uchida, S
• Unal, AU
• Urban, ML
• Usui, J
• Vaglio, A
• Venkatachalam, S
• Vermaak, E
• Viswanath, V
• Wada, T
• Wagh, S
• Wallace, DJ
• Walters, G
• Walz, B
• Wan, J
• Wang, T
• Wang, G
• Warrington, KJ
• Watts, RA
• Wawrzycka-Adamczyk, K
• Weeratunga, P
• Weisman, MH
• Wickramasinghe, S
• Williams, M
• Wojcik, K
• Woodruff, L
• Xenitidis, T
• Yamada, H
• Yamagata, K
• Yee, C
• Yoon, M
• Yoshida, K
• Yoshifuji, H
• Ytterberg, SR
• Yumura, W
• Zayed, H
• Zeng, X
• Zhao, M
• Zugaj, A
• Zuk, J

Unidades de investigação

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Neurociências Clínicas e Saúde Mental

Abstract

Objectives. 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. Methods. 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: <65years or >= 65years. We adjusted associations for the type of AAV and the type of ANCA (anti-MPO, anti-PR3 or negative). Results. A total of 1338 patients with AAV were included: 66% had disease onset at <65years of age [female 50%; mean age 48.4years (S.D. 12.6)] and 34% had disease onset at >= 65years [female 54%; mean age 73.6years (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 6month 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]. Conclusion. Within 6 months of diagnosis of AAV, patients >65years of age display a different pattern of organ involvement and an increased risk of significant damage and mortality compared with younger patients.

© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Keywords

• age; anti-neutrophil cytoplasmic antibody–associated vasculitis; outcome