Sergey Moiseev1,2, Andreas Kronbichler3, Egor Makarov2, Nikolay Bulanov1, Matija Crnogorac4, Haner Direskeneli5, Kresimir Galesic4, Ummugulsum Gazel5, Duvuru Geetha6, Loic Guillevin7, Zdenka Hrušková8, Mark A Little9,10, Adeel Ahmed11, Stephen P McAdoo12, Aladdin J Mohammad13,14, Sarah Moran9, Pavel Novikov1, Charles D Pusey12, Chinar Rahmattulla15, Veronika Satrapová8, Joana Silva12, Benjamin Terrier7, Vladimír Tesař8, Kerstin Westman16, David R W Jayne17. 1. Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University. 2. Faculty of Medicine, Lomonosov Moscow State University, Moscow, Russia. 3. Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria. 4. Department of Nephrology and Dialysis, Dubrava University Hospital, Zagreb, Croatia. 5. Department of Internal Medicine, Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey. 6. Division of Nephrology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA. 7. Department of Internal Medicine, National Referral Center for Rare Systemic and Autoimmune Diseases, Hôpital Cochin, Paris, France. 8. Department of Nephrology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Prague, Czech Republic. 9. Trinity Health Kidney Centre, Trinity Translational Medicine Institute. 10. Irish Centre for Vascular Biology, Tallaght University Hospital. 11. Beaumont Hospital, Dublin, Ireland. 12. Department of Medicine, Centre for Inflammatory Disease, Imperial College London, London, UK. 13. Department of Rheumatology, Skåne University Hospital, Lund, Sweden. 14. Vasculitis and Lupus Clinic, Addenbrooke's Hospital Cambridge University Hospitals, Cambridge, UK. 15. Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands. 16. Department of Clinical Sciences Lund, Nephrology, Lund University, Lund, Sweden. 17. Department of Medicine, University of Cambridge, Cambridge, UK.
Abstract
OBJECTIVE: To investigate the occurrence of venous thromboembolic events (VTE) in a large cohort of patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) across the European Union, Turkey, Russia, UK and North America. METHODS: Patients with a definite diagnosis of AAV who were followed for at least 3 months and had sufficient documentation were included. Data on VTE, including either deep vein thrombosis or pulmonary embolism, were collected retrospectively from tertiary vasculitis centres. Univariate and multivariate regression models were used to estimate odds ratios (ORs) and 95% CIs. RESULTS: Over a median follow-up of 63 (interquartile range: 29, 101) months, VTE occurred in 278 (9.7%) of 2869 AAV patients with a similar frequency across different countries (from 6.3% to 13.7%), and AAV subtype [granulomatosis with polyangiitis: 9.8% (95% CI: 8.3, 11.6%); microscopic polyangiitis: 9.6% (95% CI: 7.9, 11.4%); and eosinophilic granulomatosis with polyangiitis: 9.8% (95% CI: 7.0, 13.3%)]. Most VTE (65.6%) were reported in the first-year post-diagnosis. Multiple factor logistic regression analysis adjusted for sex and age showed that skin (OR 1.71, 95% CI: 1.01, 2.92), pulmonary (OR 1.78, 95% CI: 1.04, 3.14) and kidney [eGFR 15-60 ml/min/1.73 m2, OR 2.86 (95% CI: 1.27, 6.47); eGFR <15 ml/min/1.73 m2, OR 6.71 (95% CI: 2.94, 15.33)] involvement were independent variables associated with a higher occurrence of VTE. CONCLUSION: Two-thirds of VTE occurred during the initial phase of active disease. We confirmed previous findings from smaller studies that a decrease in kidney function, skin involvement and pulmonary disease are independently associated with VTE.
OBJECTIVE: To investigate the occurrence of venous thromboembolic events (VTE) in a large cohort of patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) across the European Union, Turkey, Russia, UK and North America. METHODS: Patients with a definite diagnosis of AAV who were followed for at least 3 months and had sufficient documentation were included. Data on VTE, including either deep vein thrombosis or pulmonary embolism, were collected retrospectively from tertiary vasculitis centres. Univariate and multivariate regression models were used to estimate odds ratios (ORs) and 95% CIs. RESULTS: Over a median follow-up of 63 (interquartile range: 29, 101) months, VTE occurred in 278 (9.7%) of 2869 AAV patients with a similar frequency across different countries (from 6.3% to 13.7%), and AAV subtype [granulomatosis with polyangiitis: 9.8% (95% CI: 8.3, 11.6%); microscopic polyangiitis: 9.6% (95% CI: 7.9, 11.4%); and eosinophilic granulomatosis with polyangiitis: 9.8% (95% CI: 7.0, 13.3%)]. Most VTE (65.6%) were reported in the first-year post-diagnosis. Multiple factor logistic regression analysis adjusted for sex and age showed that skin (OR 1.71, 95% CI: 1.01, 2.92), pulmonary (OR 1.78, 95% CI: 1.04, 3.14) and kidney [eGFR 15-60 ml/min/1.73 m2, OR 2.86 (95% CI: 1.27, 6.47); eGFR <15 ml/min/1.73 m2, OR 6.71 (95% CI: 2.94, 15.33)] involvement were independent variables associated with a higher occurrence of VTE. CONCLUSION: Two-thirds of VTE occurred during the initial phase of active disease. We confirmed previous findings from smaller studies that a decrease in kidney function, skin involvement and pulmonary disease are independently associated with VTE.
Authors: Giorgio Trivioli; Ana Marquez; Davide Martorana; Michelangelo Tesi; Andreas Kronbichler; Paul A Lyons; Augusto Vaglio Journal: Nat Rev Rheumatol Date: 2022-09-15 Impact factor: 32.286
Authors: Alana Nevares; Kinanah Yaseen; Hiromichi Tamaki; James Bena; William Messner; Alexandra Villa-Forte Journal: Rheumatol Adv Pract Date: 2022-07-01