TY - JOUR
T1 - Do adult disease severity subclassifications predict use of cyclophosphamide in children with ANCA-associated vasculitis? An analysis of ARChiVe study treatment decisions
AU - Morishita, Kimberly
AU - Guzman, Jaime
AU - Chira, Peter
AU - Muscal, Eyal
AU - Zeft, Andrew
AU - Klein-Gitelman, Marisa
AU - Uribe, America G.
AU - Abramson, Leslie
AU - Benseler, Susanne M.
AU - Eberhard, Anne
AU - Ede, Kaleo
AU - Hashkes, Philip J.
AU - Hersh, Aimee O.
AU - Higgins, Gloria
AU - Imundo, Lisa F.
AU - Jung, Lawrence
AU - Kim, Susan
AU - Kingsbury, Daniel J.
AU - Lawson, Erica F.
AU - Lee, Tzielan
AU - Li, Suzanne C.
AU - Lovell, Daniel J.
AU - Mason, Thomas
AU - McCurdy, Deborah
AU - O'Neil, Kathleen M.
AU - Punaro, Marilynn
AU - Ramsey, Suzanne E.
AU - Reiff, Andreas
AU - Rosenkranz, Margalit
AU - Schikler, Kenneth N.
AU - Scuccimarri, Rosie
AU - Singer, Nora G.
AU - Stevens, Anne M.
AU - Van Mater, Heather
AU - Wahezi, Dawn M.
AU - White, Andrew J.
AU - Cabral, David A.
PY - 2012/10
Y1 - 2012/10
N2 - Objective. To determine whether adult disease severity subclassification systems for antineutrophil cytoplasmic antibody-associated vasculitis (AAV) are concordant with the decision to treat pediatric patients with cyclophosphamide (CYC). Methods. We applied the European Vasculitis Study (EUVAS) and Wegener's Granulomatosis Etanercept Trial (WGET) disease severity subclassification systems to pediatric patients with AAV in A Registry for Childhood Vasculitis (ARChiVe). Modifications were made to the EUVAS and WGET systems to enable their application to this cohort of children. Treatment was categorized into 2 groups, "cyclophosphamide" and "no cyclophosphamide." Pearson's chi-square and Kendall's rank correlation coefficient statistical analyses were used to determine the relationship between disease severity subgroup and treatment at the time of diagnosis. Results. In total, 125 children with AAV were studied. Severity subgroup was associated with treatment group in both the EUVAS (chi-square 45.14, p < 0.001, Kendall's tau-b 0.601, p < 0.001) and WGET (chi-square 59.33, p < 0.001, Kendall's tau-b 0.689, p < 0.001) systems; however, 7 children classified by both systems as having less severe disease received CYC, and 6 children classified as having severe disease by both systems did not receive CYC. Conclusion. In this pediatric AAV cohort, the EUVAS and WGET adult severity subclassification systems had strong correlation with physician choice of treatment. However, a proportion of patients received treatment that was not concordant with their assigned severity subclass. The Journal of Rheumatology
AB - Objective. To determine whether adult disease severity subclassification systems for antineutrophil cytoplasmic antibody-associated vasculitis (AAV) are concordant with the decision to treat pediatric patients with cyclophosphamide (CYC). Methods. We applied the European Vasculitis Study (EUVAS) and Wegener's Granulomatosis Etanercept Trial (WGET) disease severity subclassification systems to pediatric patients with AAV in A Registry for Childhood Vasculitis (ARChiVe). Modifications were made to the EUVAS and WGET systems to enable their application to this cohort of children. Treatment was categorized into 2 groups, "cyclophosphamide" and "no cyclophosphamide." Pearson's chi-square and Kendall's rank correlation coefficient statistical analyses were used to determine the relationship between disease severity subgroup and treatment at the time of diagnosis. Results. In total, 125 children with AAV were studied. Severity subgroup was associated with treatment group in both the EUVAS (chi-square 45.14, p < 0.001, Kendall's tau-b 0.601, p < 0.001) and WGET (chi-square 59.33, p < 0.001, Kendall's tau-b 0.689, p < 0.001) systems; however, 7 children classified by both systems as having less severe disease received CYC, and 6 children classified as having severe disease by both systems did not receive CYC. Conclusion. In this pediatric AAV cohort, the EUVAS and WGET adult severity subclassification systems had strong correlation with physician choice of treatment. However, a proportion of patients received treatment that was not concordant with their assigned severity subclass. The Journal of Rheumatology
KW - Antineutrophil cytoplasmic antibodies
KW - Cyclophosphamide
KW - Pediatric vasculitis
KW - Severity
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UR - http://www.scopus.com/inward/citedby.url?scp=84867272753&partnerID=8YFLogxK
U2 - 10.3899/jrheum.120299
DO - 10.3899/jrheum.120299
M3 - Article
C2 - 22859342
AN - SCOPUS:84867272753
SN - 0315-162X
VL - 39
SP - 2012
EP - 2020
JO - Journal of Rheumatology
JF - Journal of Rheumatology
IS - 10
ER -