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- A nd 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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 617-628 |
| Number of pages | 12 |
| Journal | Rheumatology (United Kingdom) |
| Volume | 60 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2021 |
Keywords
- age
- anti-neutrophil cytoplasmic antibody-associated vasculitis
- outcome
ASJC Scopus subject areas
- Rheumatology
- Pharmacology (medical)
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In: Rheumatology (United Kingdom), Vol. 60, No. 2, 01.02.2021, p. 617-628.
Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Association between age at disease onset of anti-neutrophil cytoplasmic antibody-associated vasculitis and clinical presentation and short-term outcomes
AU - Monti, Sara
AU - Craven, Anthea
AU - Klersy, Catherine
AU - Montecucco, Carlomaurizio
AU - Caporali, Roberto
AU - Watts, Richard
AU - Merkel, Peter A.
AU - Luqmani, Raashid
AU - Achilleos, Katerina
AU - Adler, Matthew
AU - Alba, Marco A.
AU - Albert, Daniel A.
AU - Alibaz-Oner, Fatma
AU - Allcoat, Paul
AU - Amano, Koichi
AU - Amarasuriya, Manishka
AU - Amudala, Naomi A.
AU - Andrews, Jacqueline
AU - Archer, Amy M.
AU - Arimura, Yoshihiro
AU - Atukorala, Inoshi
AU - Azevedo, Elsa
AU - Bajad, Shruti
AU - Baldwin, Corisande
AU - Barra, Lillian J.
AU - Baslund, Bo
AU - Basu, Neil
AU - Baykal, Mahire
AU - Berger, Christoph
AU - Berglin, Ewa
AU - Besada, Emilio
AU - Bhardwaj, Mamta
AU - Bischof, Antje
AU - Blockmans, Daniel
AU - Blood, Janet
AU - Draibe, Juliana Bordignon
AU - Brand, Sarah
AU - Brandao, Mariana
AU - Bruce, Ian N.
AU - Butler, Amanda
AU - Calabrese, Leonard H.
AU - Ferrer, Daniel Camprubi
AU - Carette, Simon
AU - Carmona, Diana
AU - Ceunen, Helga
AU - Chakravarty, Kuntal
AU - Chapman, Peter T.
AU - Chocova, Zdenka
AU - Chung, Sharon A.
AU - Ci, Weiping
AU - Cid, Maria C.
AU - Clark, Tiffany M.
AU - Clarkson, Michael R.
AU - De Jesus Contreras-Rodríguez, Felipe
AU - Conway, Richard
AU - Cooke, Kelly
AU - Virós, Xavier Corbella
AU - Cordeiro, Ana
AU - Costa, Andreia
AU - Craven, Anthea
AU - Culfear, Karen
AU - Daikeler, Thomas
AU - Danda, Debashish
AU - Das, Siddharth K.
AU - Dasgupta, Bhaskar
AU - De Castro, Alice M.
AU - Dehghan, Natasha
AU - Devassy, Roni
AU - Dhindsa, Navjot
AU - Diamantopoulos, Andreas P.
AU - Direskeneli, Haner
AU - Dobashi, Hiroaki
AU - Juan, Du
AU - Durrani, Maumer
AU - Edelsten, Clive
AU - Eifert, Johanna
AU - Elhayek, Sallie
AU - Elsideeg, Sunhoury
AU - Endo, Tomomi
AU - Erden, Abdulsamet
AU - Erer, Burak
AU - Eriksson, Per
AU - Erturk, Zeynep
AU - Espígol-Frigolé, Georgina
AU - Felicetti, Mara
AU - Ferraro, Alaistair
AU - Ferro, José M.
AU - Fifi-Mah, Aurore
AU - Flores-Suárez, Luis Felipe
AU - Flossmann, Oliver
AU - Flynn, Deirdre
AU - Fonseca, Joaõ Eurico
AU - Foot, Jayne
AU - Foote, Michelle
AU - Forbess, Lindsy
AU - Fujimoto, Shouichi
AU - Fukuoka, Kazuhito
AU - Furtado, Carolina
AU - Furuta, Shunsuke
AU - Gaffo, Angelo L.
AU - Gallagher, Phil
AU - Gao, Na
AU - Gatenby, Paul
AU - Gendi, Nagui
AU - Geraldes, Ruth
AU - Gerits, Anneleen
AU - Gioffredi, Andrea
AU - Gomples, Luke
AU - Goncąlves, Maria Joaõ
AU - Gondo, Prisca
AU - Graham, Anne
AU - Grainger, Rebecca
AU - Gray, David T.
AU - Grayson, Peter C.
AU - Griffiths, Laura
AU - Guo, Yanqiu
AU - Gupta, Rajiva
AU - Gylling, Micael
AU - Hajj-Ali, Rula A.
AU - Hammam, Nevin
AU - Harigai, Masayoshi
AU - Hartley, Lorraine
AU - Haslett, Janine
AU - Hassan, Alaa
AU - Hatemi, Gulen
AU - Hellmich, Bernhard
AU - Henckaerts, Liesbet
AU - Henes, Joerg C.
AU - Hepburn, Joanna
AU - Herd, Vera
AU - Hess, Christoph
AU - Hill, Catherine
AU - Hinojosa-Azaola, Andrea
AU - Hirahashi, Junichi
AU - Hirano, Fumio
AU - Hočevar, Alojzija
AU - Holle, Julia
AU - Hollinger, Nicole
AU - Homma, Sakae
AU - Howard, Theresa
AU - Hoyles, Rachel K.
AU - Hruskova, Zdenka
AU - Hutcheon, Gayle
AU - Ignacak, Maria
AU - Igney-Oertel, Annette
AU - Ikeda, Kei
AU - Ikegaya, Noriko
AU - Jagadeesh, Samyukta
AU - Jaquith, Jane
AU - Jayne, David R.W.
AU - Jewell, Teresa
AU - Jones, Colin
AU - Joshi, Abhay
AU - Kalyoncu, Umut
AU - Kamall, Sevil
AU - Kamath, Sanjeet
AU - Lai, Kan Sow
AU - Kaname, Shinya
AU - Kanchinadham, Suresh
AU - Karadaǧ, Ömer
AU - Karube, Miho
AU - Kaszuba, Marek
AU - Kaur, Ramanjot
AU - Kawakami, Tamihiro
AU - Kawashima, Soko
AU - Khalidi, Nader
AU - Khan, Asad
AU - Kikuchi, Masao
AU - Kilic, Levent
AU - Kimura, Makiko
AU - King, Maria J.
AU - Klapa, Sebastian
AU - Klocke, Rainer
AU - Kobayashi, Tatsuo
AU - Kobayashi, Shigeto
AU - Komagata, Yoshinori
AU - Kronbichler, Andreas
AU - Kuczia, Pawel
AU - Kumar, Mandal Santosh
AU - Kurosawa, Miho
AU - Lamprecht, Peter
AU - Langford, Carol A.
AU - Lanyon, Peter
AU - Laversuch, Catherine
AU - Lee, Sang Jin
AU - Leoni, Simona
AU - Li, Jing
AU - Liang, Kimberly
AU - Liang, Patrick
AU - Liao, Hua
AU - Lee, Lim Ai
AU - Luqmani, Raashid A.
AU - Lyle, Amanda
AU - Macdonald, Matthew
AU - Mackie, Sarah L.
AU - Madden, Leah
AU - Magliano, Malgorzata
AU - Makino, Hirofumi
AU - Makol, Ashima
AU - Malaiya, Ritu
AU - Malaviya, Anshuman
AU - Manthri, Ramesh
AU - Maritati, Federica
AU - Da Silva, Ana Martins
AU - Mason, Justin C.
AU - Matara, Cecilia
AU - Matsui, Kazuo
AU - Matteson, Eric L.
AU - Mcbride, Dawn
AU - Mccullough, Keith
AU - Mcgeoch, Lucy
AU - Mclaren, John
AU - Mcmillian, Caitlin
AU - Mendiratta, Naval
AU - Menon, Ajit
AU - Merinopoulos, Dimos
AU - Merkel, Peter A.
AU - Merkel, Peter
AU - Messier, Sandra
AU - Micheletti, Robert G.
AU - Mills, Karen
AU - Milman, Nataliya
AU - Minoda, Masahiro
AU - Minz, Ranjana Walker
AU - Möck, Claudia
AU - Mohammad, Aladdin J.
AU - Moiseev, Sergey
AU - Moitinho, Marta
AU - Molloy, Eamonn
AU - Monach, Paul A.
AU - Montgomery, Marian
AU - Moosig, Frank
AU - Moradizadeh, Manoosh
AU - Morgan, Matthew
AU - Morgan, Ann W.
AU - Morgan, Ann Marie
AU - Muir, Alice
AU - Mukhtyar, Chetan
AU - Müller, Antje
AU - Muratore, Francesco
AU - Muso, Eri
AU - Nada, Ritambhra
AU - Nakajima, Hiroshi
AU - Nakajima, Toshiki
AU - Nakano, Hiroto
AU - Nandagudi, Anupapama
AU - Neumann, Thomas
AU - Ng, Ying Fun
AU - Ng, Kooi Heng
AU - Nogueira, Estela L.
AU - Nolkha, Nilesh
AU - Nordström, Dan
AU - Novikov, Pavel
AU - Nugaliyadde, Asanka
AU - O'donnell, John L.
AU - O'donoghue, Jennifer
AU - O'neill, Lorraine
AU - O'riordan, Edmond
AU - Oatley, Margaret
AU - Okubo, Koshu
AU - Oliva, Elena
AU - Oshikawa, Hideto
AU - Ota, Yuichiro
AU - Padoan, Roberto
AU - Pagnoux, Christian
AU - Pan, Lili
AU - Panaritis, Kalliopi
AU - Park, Jin Kyun
AU - Patel, Sanjeev
AU - Patil, Pravin
AU - Pazzola, Giulia
AU - Peall, Adrian
AU - Pearce, Fiona
AU - Pehlevan, Seval
AU - Pereira, Liliana
AU - Pettersson, Tom
AU - Pineau, Christian A.
AU - Pirilä, Laura
AU - Poglodek, Bartlomiej
AU - Ponte, Cristina
AU - Prieto-González, Sergio
AU - Priya, Sangeetha R.
AU - Purewal, Bally
AU - Purschke, Silke
AU - Putaala, Jukka
AU - Quickert, Stefanie
AU - Quincey, Vicki
AU - Raghuvanshi, Subhra
AU - Rajasekhar, Liza
AU - Ranganathan, Dwarakanathan
AU - Rathi, Manish
AU - Rees, David
AU - Rees, Frances
AU - Renken, Ulrike
AU - Restuccia, Giovanna
AU - Rhee, Rennie L.
AU - Rice, Brian
AU - Robins, Diane
AU - Robson, Joanna
AU - Rodrigues, Miguel
AU - Romaõ, Vasco C.
AU - Rotar, Ciga
AU - Ruediger, Carlee
AU - Rutgers, Abraham
AU - Sá, Ana C.
AU - Saavedra, Maria Joaõ
AU - Sada, Ken Ei
AU - Sahbudin, Ilfita
AU - Salvarani, Carlo
AU - Sandhu, Namneet
AU - Santos, Ernestina
AU - Sato, Yuji
AU - Schäfer, Valentin S.
AU - Schiavon, Franco
AU - Schmidt, Wolfgang A.
AU - Segelmark, Mårten
AU - Shahin, Amira
AU - Sharma, Aman
AU - Shotton, Julie
AU - Silva, Cristiana
AU - Singer, Ora Gewurz
AU - Sivasuthan, Goutham
AU - Smolen, Susan
AU - Solanich-Moreno, Xavier
AU - Boixader, Laura Soldevila
AU - Song, Yeong Wook
AU - Springer, Jason
AU - Sreih, Antoine G.
AU - Srivastava, Ragini
AU - Stamp, Lisa K.
AU - Stevens, Robert
AU - Strbian, Daniel
AU - Sugino, Keishi
AU - Sunderkötter, Cord
AU - Suppiah, Ravi
AU - Suzuki, Katsuya
AU - Suzuki, Kazuo
AU - Szekanecz, Zoltán
AU - Sznajd, Jan
AU - Taimen, Kirsi
AU - Tak, Paul P.
AU - Takeuchi, Tsutomu
AU - Takizawa, Naoho
AU - Tames, Lilian
AU - Tan, Bee Eng
AU - Tanaka, Mototsugu
AU - Tang, Man Wai
AU - Tatlisumak, Turgut
AU - Tesar, Vladimir
AU - Thomas, Alan
AU - Tian, Xinping
AU - Tokunaga, Kenichiro
AU - Tombetti, Enrico
AU - Tomšič, Matija
AU - Toz, Bahtiyar
AU - Tsukamoto, Tatsuo
AU - Uchida, Shunya
AU - Unal, Ali Ugur
AU - Urban, Maria L.
AU - Usui, Joichi
AU - Vaglio, Augusto
AU - Venkatachalam, Srinivasan
AU - Vermaak, Erin
AU - Viswanath, Vishad
AU - Wada, Takashi
AU - Wagh, Shrikant
AU - Wallace, Daniel J.
AU - Walters, Giles
AU - Walz, Bastian
AU - Wan, Jin
AU - Wang, Tian
AU - Wang, Guochun
AU - Warrington, Kenneth J.
AU - Watts, Richard A.
AU - Wawrzycka-Adamczyk, Katarzyna
AU - Weeratunga, Praveen
AU - Weisman, Michael H.
AU - Wickramasinghe, Sugeesha
AU - Williams, Mark
AU - Williams, Megan
AU - Wojcik, Krzysztof
AU - Woodruff, Laticia
AU - Xenitidis, Theodoros
AU - Yamada, Hidehiro
AU - Yamagata, Kunihiro
AU - Yee, Chee Seng
AU - Yoon, Myeongjae
AU - Yoshida, Kazuki
AU - Yoshifuji, Hajime
AU - Ytterberg, Steven R.
AU - Yumura, Wako
AU - Zayed, Hania
AU - Zeng, Xiaofeng
AU - Zhao, Ming Hui
AU - Zugaj, Anna
AU - Zuk, Joanna
N1 - Publisher Copyright: © 2020 The Author(s). Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
PY - 2021/2/1
Y1 - 2021/2/1
N2 - 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- A nd 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.
AB - 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- A nd 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.
KW - age
KW - anti-neutrophil cytoplasmic antibody-associated vasculitis
KW - outcome
UR - http://www.scopus.com/inward/record.url?scp=85090068067&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85090068067&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/keaa215
DO - 10.1093/rheumatology/keaa215
M3 - Article
C2 - 32447389
AN - SCOPUS:85090068067
SN - 1462-0324
VL - 60
SP - 617
EP - 628
JO - Rheumatology (United Kingdom)
JF - Rheumatology (United Kingdom)
IS - 2
ER -