Association between age at disease onset of anti-neutrophil cytoplasmic antibody–associated vasculitis and clinical presentation and short-term outcomes.
| Autor: | Monti, Sara, Craven, Anthea, Klersy, Catherine, Montecucco, Carlomaurizio, Caporali, Roberto, Watts, Richard, Merkel, Peter A, Luqmani, Raashid, Collaborators, DCVAS |
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| Předmět: |
AGE distribution
AGE factors in disease AUTOIMMUNE diseases CARDIOVASCULAR diseases COMPARATIVE studies CONFIDENCE intervals CUTANEOUS manifestations of general diseases KIDNEY diseases MUSCULOSKELETAL system diseases NEUROLOGIC manifestations of general diseases OTOLARYNGOLOGY VASCULITIS DESCRIPTIVE statistics ANTINEUTROPHIL cytoplasmic antibodies SYMPTOMS ADULTS MIDDLE age OLD age |
| Zdroj: | Rheumatology; Feb2021, Vol. 60 Issue 2, p617-628, 12p |
| Abstrakt: | 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: <65 years or ≥65 years. 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 <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]. Conclusion Within 6 months of diagnosis of AAV, patients >65 years of age display a different pattern of organ involvement and an increased risk of significant damage and mortality compared with younger patients. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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