Grzegorz Biedroń1, Anna Włudarczyk1, Katarzyna Wawrzycka-Adamczyk1, Krzysztof Wójcik1, Jan Sznajd2, Zbigniew Zdrojewski3, Anna Masiak3, Zenobia Czuszyńska3, Maria Majdan4, Radosław Jeleniewicz4, Marian Klinger5, Katarzyna Jakuszko6, Olumide Olatubosun Rowaiye6, Marek Brzosko7, Iwona Brzosko7, Alicja Dębska-Ślizień8, Hanna Storoniak8, Witold Tłustochowicz9, Joanna Kur-Zalewska9, Małgorzata Wisłowska10, Marta Madej11, Anna Hawrot-Kawecka12, Piotr Głuszko13, Eugeniusz J Kucharz14, Jacek Musiał1, Wojciech Szczeklik15. 1. 2nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland. 2. Department of Rheumatology, Raigmore Hospital, Inverness, UK; Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK. 3. Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland. 4. Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Lublin, Poland. 5. Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland; Department of Nephrology, Institute of Medicine University of Opole, Opole University Hospital, Opole, Poland. 6. Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland. 7. Department of Rheumatology and Internal Diseases, Pomeranian Medical University in Szczecin, Szczecin, Poland. 8. Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdansk, Gdansk, Poland. 9. Department of Internal Medicine and Rheumatology, Military Medical Institute, Warszawa, Poland. 10. Department of Internal Diseases and Rheumatology, Central Clinical Hospital of the Ministry of the Interior and Administration, Warszawa, Poland. 11. Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Wroclaw, Poland. 12. Department of Internal Medicine and Metabolic Diseases, Medical University of Silesia, Katowice, Poland. 13. Department of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warszawa, Poland. 14. Department of Internal Medicine, Rheumatology and Clinical Immunology, Medical University of Silesia, Katowice, Poland. 15. 2nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland. Electronic address: wojciech.szczeklik@uj.edu.pl.
Abstract
PURPOSE: The aim of this study is to present the treatment modalities and associated side effects in a Polish nation-wide ANCA-associated vasculitides (AAV) patients' cohort. MATERIALS AND METHODS: Retrospective analysis of patients diagnosed with AAV between 1990 and 2016, included in the POLVAS registry was performed. Standard descriptive statistic methods were used with an emphasis on the treatment modalities. RESULTS: There were 625 patients diagnosed with AAV included in this study: 417 cases of granulomatosis with polyangiitis (GPA; 66.7%), 106 cases of microscopic polyangiitis (MPA; 17.0%) and 102 cases of eosinophilic granulomatosis with polyangiitis (EGPA; 16.3%). The mean age at the date of diagnosis was 50.4 (±15.7) years and the median observational period amounted to 4.0 (2.0-8.0) years. Glucocorticosteroids (GCs) were the medicaments most frequently used for remission induction (593/622; 95.3%), followed by cyclophosphamide (487/622; 78.3%), rituximab (44/622; 7.1%), and methotrexate (39/622; 6.3%). GCs were also most frequently administered for maintenance therapy (499/592; 84.3%), followed by azathioprine (224/592; 37.8%), methotrexate (136/592; 23.0%) and mycophenolate mofetil (99/592; 16.7%). The median cumulative doses of cyclophosphamide and rituximab equalled 7.99 g (4.18-14.0) and 2000 mg (1500-2800), respectively. The most commonly observed adverse events included: infections - 214/551 cases (38.8%), which were associated with the time of observation (OR = 1.05; 95% CI 1.01-1.10), the use of GCs intravenous pulses (OR = 2.76; 95% CI 1.68-4.54) and need for haemodialysis (OR = 1.73; 95% CI 1.10-2.71). CONCLUSIONS: Polish patients with AAV were predominantly treated according to appropriate guidelines. The most frequent adverse events were typical for usually administered immunosuppressive treatment.
PURPOSE: The aim of this study is to present the treatment modalities and associated side effects in a Polish nation-wide ANCA-associated vasculitides (AAV) patients' cohort. MATERIALS AND METHODS: Retrospective analysis of patients diagnosed with AAV between 1990 and 2016, included in the POLVAS registry was performed. Standard descriptive statistic methods were used with an emphasis on the treatment modalities. RESULTS: There were 625 patients diagnosed with AAV included in this study: 417 cases of granulomatosis with polyangiitis (GPA; 66.7%), 106 cases of microscopic polyangiitis (MPA; 17.0%) and 102 cases of eosinophilic granulomatosis with polyangiitis (EGPA; 16.3%). The mean age at the date of diagnosis was 50.4 (±15.7) years and the median observational period amounted to 4.0 (2.0-8.0) years. Glucocorticosteroids (GCs) were the medicaments most frequently used for remission induction (593/622; 95.3%), followed by cyclophosphamide (487/622; 78.3%), rituximab (44/622; 7.1%), and methotrexate (39/622; 6.3%). GCs were also most frequently administered for maintenance therapy (499/592; 84.3%), followed by azathioprine (224/592; 37.8%), methotrexate (136/592; 23.0%) and mycophenolate mofetil (99/592; 16.7%). The median cumulative doses of cyclophosphamide and rituximab equalled 7.99 g (4.18-14.0) and 2000 mg (1500-2800), respectively. The most commonly observed adverse events included: infections - 214/551 cases (38.8%), which were associated with the time of observation (OR = 1.05; 95% CI 1.01-1.10), the use of GCs intravenous pulses (OR = 2.76; 95% CI 1.68-4.54) and need for haemodialysis (OR = 1.73; 95% CI 1.10-2.71). CONCLUSIONS: Polish patients with AAV were predominantly treated according to appropriate guidelines. The most frequent adverse events were typical for usually administered immunosuppressive treatment.