Sung Soo Ahn1, Jang Woo Ha2, Yong-Beom Park2,3, Sang-Won Lee4,5. 1. Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea. 2. Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. 3. Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea. 4. Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. sangwonlee@yuhs.ac. 5. Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea. sangwonlee@yuhs.ac.
Abstract
INTRODUCTION/ OBJECTIVES: Birmingham vasculitis activity score (BVAS) version 3 (BVAS 3.0) and BVAS/granulomatosis with polyangiitis (BVAS/GPA) are used as indicators of disease activity in anti-neutrophil cytoplasmic antibody-associated vasculitis. We evaluated the association between these indices and the significance in patients with GPA and microscopic polyangiitis (GPA/MPA). METHODS: We retrospectively reviewed the records of 203 patients with GPA/MPA in our hospital. The correlation between BVAS 3.0 and BVAS/GPA with the five-factor score (FFS) and laboratory data was investigated. The episodes of all-cause mortality, end-stage renal disease, and disease relapse were counted as adverse clinical outcomes. Multivariate Cox hazard analyses were performed to assess the relationships between both indices and patient outcomes. RESULTS: Sixty-five (32.0%) and 138 (68.0%) patients with GPA and MPA were included. The median BVAS 3.0 was significantly higher in patients with MPA than in those with GPA (13.0 vs. 11.0, p = 0.015), whereas BVAS/GPA was higher in patients with GPA (4.0 vs. 3.0, p = 0.001). BVAS 3.0 and BVAS/GPA correlated significantly (r = 0.670, p < 0.001); both BVAS 3.0 and BVAS/GPA were shown to be associated with the outcomes investigated in separate Cox models. However, the correlation between BVAS 3.0 and BVAS/GPA was especially higher in a subgroup of patients with MPA than in those with GPA (MPA: r = 0.817, p < 0.001 vs. GPA: r = 0.570, p < 0.001) and with renal involvement (r = 0.676, p < 0.001). CONCLUSIONS: Although both BVAS 3.0 and BVAS/GPA significantly correlated and predicted outcomes well in those with GPA/MPA, a discord was observed based on disease subtypes and organ involvement. Key Points • BVAS 3.0 and BVAS/GPA significantly correlated and predicted outcomes in those with GPA/MPA. • A discordance was also observed based on disease subtypes and organ involvement.
INTRODUCTION/ OBJECTIVES: Birmingham vasculitis activity score (BVAS) version 3 (BVAS 3.0) and BVAS/granulomatosis with polyangiitis (BVAS/GPA) are used as indicators of disease activity in anti-neutrophil cytoplasmic antibody-associated vasculitis. We evaluated the association between these indices and the significance in patients with GPA and microscopic polyangiitis (GPA/MPA). METHODS: We retrospectively reviewed the records of 203 patients with GPA/MPA in our hospital. The correlation between BVAS 3.0 and BVAS/GPA with the five-factor score (FFS) and laboratory data was investigated. The episodes of all-cause mortality, end-stage renal disease, and disease relapse were counted as adverse clinical outcomes. Multivariate Cox hazard analyses were performed to assess the relationships between both indices and patient outcomes. RESULTS: Sixty-five (32.0%) and 138 (68.0%) patients with GPA and MPA were included. The median BVAS 3.0 was significantly higher in patients with MPA than in those with GPA (13.0 vs. 11.0, p = 0.015), whereas BVAS/GPA was higher in patients with GPA (4.0 vs. 3.0, p = 0.001). BVAS 3.0 and BVAS/GPA correlated significantly (r = 0.670, p < 0.001); both BVAS 3.0 and BVAS/GPA were shown to be associated with the outcomes investigated in separate Cox models. However, the correlation between BVAS 3.0 and BVAS/GPA was especially higher in a subgroup of patients with MPA than in those with GPA (MPA: r = 0.817, p < 0.001 vs. GPA: r = 0.570, p < 0.001) and with renal involvement (r = 0.676, p < 0.001). CONCLUSIONS: Although both BVAS 3.0 and BVAS/GPA significantly correlated and predicted outcomes well in those with GPA/MPA, a discord was observed based on disease subtypes and organ involvement. Key Points • BVAS 3.0 and BVAS/GPA significantly correlated and predicted outcomes in those with GPA/MPA. • A discordance was also observed based on disease subtypes and organ involvement.
Authors: J H Stone; G S Hoffman; P A Merkel; Y I Min; M L Uhlfelder; D B Hellmann; U Specks; N B Allen; J C Davis; R F Spiera; L H Calabrese; F M Wigley; N Maiden; R M Valente; J L Niles; K H Fye; J W McCune; E W St Clair; R A Luqmani Journal: Arthritis Rheum Date: 2001-04
Authors: R Y Leavitt; A S Fauci; D A Bloch; B A Michel; G G Hunder; W P Arend; L H Calabrese; J F Fries; J T Lie; R W Lightfoot Journal: Arthritis Rheum Date: 1990-08
Authors: Christian Pagnoux; Thomas Quéméneur; Jacques Ninet; Elisabeth Diot; Xavier Kyndt; Benoît de Wazières; Jean-Luc Reny; Xavier Puéchal; Pierre-Yves le Berruyer; Olivier Lidove; Philippe Vanhille; Pascal Godmer; Olivier Fain; Daniel Blockmans; Boris Bienvenu; Florence Rollot; Séverine Aït el Ghaz-Poignant; Alfred Mahr; Pascal Cohen; Luc Mouthon; Elodie Perrodeau; Philippe Ravaud; Loïc Guillevin Journal: Arthritis Rheumatol Date: 2015-04 Impact factor: 10.995
Authors: C Mukhtyar; R Lee; D Brown; D Carruthers; B Dasgupta; S Dubey; O Flossmann; C Hall; J Hollywood; D Jayne; R Jones; P Lanyon; A Muir; D Scott; L Young; R A Luqmani Journal: Ann Rheum Dis Date: 2008-12-03 Impact factor: 19.103
Authors: A Richard Kitching; Hans-Joachim Anders; Neil Basu; Elisabeth Brouwer; Jennifer Gordon; David R Jayne; Joyce Kullman; Paul A Lyons; Peter A Merkel; Caroline O S Savage; Ulrich Specks; Renate Kain Journal: Nat Rev Dis Primers Date: 2020-08-27 Impact factor: 52.329