Effect of Disease Activity, Glucocorticoid Exposure, and Rituximab on Body Composition During Induction Treatment of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis

Zachary S. Wallace, Eli M. Miloslavsky, Matthew Cascino, Sebastian H. Unizony, Na Lu, Gary S. Hoffman, Cees G.M. Kallenberg, Carol A. Langford, Peter A. Merkel, Paul A. Monach, Philip Seo, Robert Spiera, E. William St.Clair, Ulrich Specks, Paul Brunetta, Hyon K. Choi, John H. Stone

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: We investigated the relationships between glucocorticoid use, disease activity, and changes in body mass index (BMI) in patients with antineutrophil cytoplasmic antibody–associated vasculitis (AAV). Methods: We analyzed AAV patients enrolled in the Rituximab in AAV trial. Glucocorticoid use, BMI, and disease activity were measured regularly during the trial period. We performed mixed-effects regressions to examine the associations of time-dependent cumulative average glucocorticoid use and disease activity with changes in BMI over time, while adjusting for potential confounders. Results: The mean ± SD baseline BMI of the 197 patients enrolled was 28.8 ± 6.3 kg/m2. Patients with newly diagnosed AAV tended to have a lower mean ± SD BMI than those with relapsing disease (28.0 ± 5.7 kg/m2 versus 29.6 ± 6.8 kg/m2) and higher disease activity (mean ± SD Birmingham Vasculitis Activity Score for Wegener's Granulomatosis 8.7 ± 3.3 versus 7.4 ± 2.7). The most significant change in BMI occurred during the first 6 months of the trial (mean ± SD increase of 1.1 ± 2.2 kg/m2; P < 0.0001). Disease activity improvement, glucocorticoid exposure, and randomization to rituximab were each independently associated with an increase in BMI (P < 0.001 for all analyses). Conclusion: Our findings suggest that changes in BMI, as well as glucocorticoid exposure, are independently associated with improvements in disease activity in AAV. Rituximab may also have effects on BMI independent of its impact on disease activity.

Original languageEnglish (US)
Pages (from-to)1004-1010
Number of pages7
JournalArthritis Care and Research
Volume69
Issue number7
DOIs
StatePublished - Jul 1 2017

Fingerprint

Vasculitis
Body Composition
Glucocorticoids
Body Mass Index
Therapeutics
Rituximab
Granulomatosis with Polyangiitis
Random Allocation

ASJC Scopus subject areas

  • Rheumatology

Cite this

Effect of Disease Activity, Glucocorticoid Exposure, and Rituximab on Body Composition During Induction Treatment of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis. / Wallace, Zachary S.; Miloslavsky, Eli M.; Cascino, Matthew; Unizony, Sebastian H.; Lu, Na; Hoffman, Gary S.; Kallenberg, Cees G.M.; Langford, Carol A.; Merkel, Peter A.; Monach, Paul A.; Seo, Philip; Spiera, Robert; St.Clair, E. William; Specks, Ulrich; Brunetta, Paul; Choi, Hyon K.; Stone, John H.

In: Arthritis Care and Research, Vol. 69, No. 7, 01.07.2017, p. 1004-1010.

Research output: Contribution to journalArticle

Wallace, ZS, Miloslavsky, EM, Cascino, M, Unizony, SH, Lu, N, Hoffman, GS, Kallenberg, CGM, Langford, CA, Merkel, PA, Monach, PA, Seo, P, Spiera, R, St.Clair, EW, Specks, U, Brunetta, P, Choi, HK & Stone, JH 2017, 'Effect of Disease Activity, Glucocorticoid Exposure, and Rituximab on Body Composition During Induction Treatment of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis', Arthritis Care and Research, vol. 69, no. 7, pp. 1004-1010. https://doi.org/10.1002/acr.23099
Wallace, Zachary S. ; Miloslavsky, Eli M. ; Cascino, Matthew ; Unizony, Sebastian H. ; Lu, Na ; Hoffman, Gary S. ; Kallenberg, Cees G.M. ; Langford, Carol A. ; Merkel, Peter A. ; Monach, Paul A. ; Seo, Philip ; Spiera, Robert ; St.Clair, E. William ; Specks, Ulrich ; Brunetta, Paul ; Choi, Hyon K. ; Stone, John H. / Effect of Disease Activity, Glucocorticoid Exposure, and Rituximab on Body Composition During Induction Treatment of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis. In: Arthritis Care and Research. 2017 ; Vol. 69, No. 7. pp. 1004-1010.
@article{4b7be83e8b6a4abfb0e58d10fa119ea1,
title = "Effect of Disease Activity, Glucocorticoid Exposure, and Rituximab on Body Composition During Induction Treatment of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis",
abstract = "Objective: We investigated the relationships between glucocorticoid use, disease activity, and changes in body mass index (BMI) in patients with antineutrophil cytoplasmic antibody–associated vasculitis (AAV). Methods: We analyzed AAV patients enrolled in the Rituximab in AAV trial. Glucocorticoid use, BMI, and disease activity were measured regularly during the trial period. We performed mixed-effects regressions to examine the associations of time-dependent cumulative average glucocorticoid use and disease activity with changes in BMI over time, while adjusting for potential confounders. Results: The mean ± SD baseline BMI of the 197 patients enrolled was 28.8 ± 6.3 kg/m2. Patients with newly diagnosed AAV tended to have a lower mean ± SD BMI than those with relapsing disease (28.0 ± 5.7 kg/m2 versus 29.6 ± 6.8 kg/m2) and higher disease activity (mean ± SD Birmingham Vasculitis Activity Score for Wegener's Granulomatosis 8.7 ± 3.3 versus 7.4 ± 2.7). The most significant change in BMI occurred during the first 6 months of the trial (mean ± SD increase of 1.1 ± 2.2 kg/m2; P < 0.0001). Disease activity improvement, glucocorticoid exposure, and randomization to rituximab were each independently associated with an increase in BMI (P < 0.001 for all analyses). Conclusion: Our findings suggest that changes in BMI, as well as glucocorticoid exposure, are independently associated with improvements in disease activity in AAV. Rituximab may also have effects on BMI independent of its impact on disease activity.",
author = "Wallace, {Zachary S.} and Miloslavsky, {Eli M.} and Matthew Cascino and Unizony, {Sebastian H.} and Na Lu and Hoffman, {Gary S.} and Kallenberg, {Cees G.M.} and Langford, {Carol A.} and Merkel, {Peter A.} and Monach, {Paul A.} and Philip Seo and Robert Spiera and St.Clair, {E. William} and Ulrich Specks and Paul Brunetta and Choi, {Hyon K.} and Stone, {John H.}",
year = "2017",
month = "7",
day = "1",
doi = "10.1002/acr.23099",
language = "English (US)",
volume = "69",
pages = "1004--1010",
journal = "Arthritis and Rheumatology",
issn = "2326-5191",
publisher = "John Wiley and Sons Ltd",
number = "7",

}

TY - JOUR

T1 - Effect of Disease Activity, Glucocorticoid Exposure, and Rituximab on Body Composition During Induction Treatment of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis

AU - Wallace, Zachary S.

AU - Miloslavsky, Eli M.

AU - Cascino, Matthew

AU - Unizony, Sebastian H.

AU - Lu, Na

AU - Hoffman, Gary S.

AU - Kallenberg, Cees G.M.

AU - Langford, Carol A.

AU - Merkel, Peter A.

AU - Monach, Paul A.

AU - Seo, Philip

AU - Spiera, Robert

AU - St.Clair, E. William

AU - Specks, Ulrich

AU - Brunetta, Paul

AU - Choi, Hyon K.

AU - Stone, John H.

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Objective: We investigated the relationships between glucocorticoid use, disease activity, and changes in body mass index (BMI) in patients with antineutrophil cytoplasmic antibody–associated vasculitis (AAV). Methods: We analyzed AAV patients enrolled in the Rituximab in AAV trial. Glucocorticoid use, BMI, and disease activity were measured regularly during the trial period. We performed mixed-effects regressions to examine the associations of time-dependent cumulative average glucocorticoid use and disease activity with changes in BMI over time, while adjusting for potential confounders. Results: The mean ± SD baseline BMI of the 197 patients enrolled was 28.8 ± 6.3 kg/m2. Patients with newly diagnosed AAV tended to have a lower mean ± SD BMI than those with relapsing disease (28.0 ± 5.7 kg/m2 versus 29.6 ± 6.8 kg/m2) and higher disease activity (mean ± SD Birmingham Vasculitis Activity Score for Wegener's Granulomatosis 8.7 ± 3.3 versus 7.4 ± 2.7). The most significant change in BMI occurred during the first 6 months of the trial (mean ± SD increase of 1.1 ± 2.2 kg/m2; P < 0.0001). Disease activity improvement, glucocorticoid exposure, and randomization to rituximab were each independently associated with an increase in BMI (P < 0.001 for all analyses). Conclusion: Our findings suggest that changes in BMI, as well as glucocorticoid exposure, are independently associated with improvements in disease activity in AAV. Rituximab may also have effects on BMI independent of its impact on disease activity.

AB - Objective: We investigated the relationships between glucocorticoid use, disease activity, and changes in body mass index (BMI) in patients with antineutrophil cytoplasmic antibody–associated vasculitis (AAV). Methods: We analyzed AAV patients enrolled in the Rituximab in AAV trial. Glucocorticoid use, BMI, and disease activity were measured regularly during the trial period. We performed mixed-effects regressions to examine the associations of time-dependent cumulative average glucocorticoid use and disease activity with changes in BMI over time, while adjusting for potential confounders. Results: The mean ± SD baseline BMI of the 197 patients enrolled was 28.8 ± 6.3 kg/m2. Patients with newly diagnosed AAV tended to have a lower mean ± SD BMI than those with relapsing disease (28.0 ± 5.7 kg/m2 versus 29.6 ± 6.8 kg/m2) and higher disease activity (mean ± SD Birmingham Vasculitis Activity Score for Wegener's Granulomatosis 8.7 ± 3.3 versus 7.4 ± 2.7). The most significant change in BMI occurred during the first 6 months of the trial (mean ± SD increase of 1.1 ± 2.2 kg/m2; P < 0.0001). Disease activity improvement, glucocorticoid exposure, and randomization to rituximab were each independently associated with an increase in BMI (P < 0.001 for all analyses). Conclusion: Our findings suggest that changes in BMI, as well as glucocorticoid exposure, are independently associated with improvements in disease activity in AAV. Rituximab may also have effects on BMI independent of its impact on disease activity.

UR - http://www.scopus.com/inward/record.url?scp=85021285629&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021285629&partnerID=8YFLogxK

U2 - 10.1002/acr.23099

DO - 10.1002/acr.23099

M3 - Article

C2 - 27696762

AN - SCOPUS:85021285629

VL - 69

SP - 1004

EP - 1010

JO - Arthritis and Rheumatology

JF - Arthritis and Rheumatology

SN - 2326-5191

IS - 7

ER -