nach oben

Clinical Rheumatology

Erschienen in:

09.07.2022 | Original Article

BVAS version 3 and BVAS/GPA: standing on the same line?

verfasst von: Sung Soo Ahn, Jang Woo Ha, Yong-Beom Park, Sang-Won Lee

Erschienen in: Clinical Rheumatology | Ausgabe 11/2022

Einloggen, um Zugang zu erhalten

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.

Nur mit Berechtigung zugänglich

Berden A, Göçeroglu A, Jayne D, Luqmani R, Rasmussen N, Bruijn JA, Bajema I (2012) Diagnosis and management of ANCA associated vasculitis. BMJ 344:e26. https://doi.org/10.1136/bmj.e26CrossRefPubMed

Yates M, Watts R (2017) ANCA-associated vasculitis. Clin Med (Lond) 17(1):60–64. https://doi.org/10.7861/clinmedicine.17-1-60CrossRef

Xiao H, Hu P, Falk RJ, Jennette JC (2016) Overview of the pathogenesis of ANCA-associated vasculitis. Kidney Dis (Basel) 1(4):205–215. https://doi.org/10.1159/000442323CrossRef

Jennette JC, Nachman PH (2017) ANCA glomerulonephritis and vasculitis. Clin J Am Soc Nephrol 12(10):1680–1691. https://doi.org/10.2215/cjn.02500317CrossRefPubMedPubMedCentral

Li W, Huang H, Cai M, Yuan T, Sheng Y (2021) Antineutrophil cytoplasmic antibody-associated vasculitis update: genetic pathogenesis. Front Immunol 12:624848. https://doi.org/10.3389/fimmu.2021.624848CrossRefPubMedPubMedCentral

Smith RM, Jones RB, Jayne DR (2012) Progress in treatment of ANCA-associated vasculitis. Arthritis Res Ther 14(2):210. https://doi.org/10.1186/ar3797CrossRefPubMedPubMedCentral

Stone JH, Hoffman GS, Merkel PA et al (2001) A disease-specific activity index for Wegener’s granulomatosis: modification of the Birmingham Vasculitis Activity Score International Network for the Study of the Systemic Vasculitides (INSSYS). Arthritis Rheum 44(4):912–920. https://doi.org/10.1002/1529-0131(200104)44:4%3c912::Aid-anr148%3e3.0.Co;2-5CrossRefPubMed

Mukhtyar C, Lee R, Brown D et al (2009) Modification and validation of the Birmingham Vasculitis Activity Score (version 3). Ann Rheum Dis 68(12):1827–1832. https://doi.org/10.1136/ard.2008.101279CrossRefPubMed

Guillevin L, Pagnoux C, Seror R, Mahr A, Mouthon L, Toumelin PL (2011) The Five-Factor Score revisited: assessment of prognoses of systemic necrotizing vasculitides based on the French Vasculitis Study Group (FVSG) cohort. Medicine (Baltimore) 90(1):19–27. https://doi.org/10.1097/MD.0b013e318205a4c6CrossRef

10.

Kitching AR, Anders HJ, Basu N, Brouwer E, Gordon J, Jayne DR, Kullman J, Lyons PA, Merkel PA, Savage COS, Specks U, Kain R (2020) ANCA-associated vasculitis. Nat Rev Dis Primers 6(1):71. https://doi.org/10.1038/s41572-020-0204-yCrossRefPubMed

11.

Pagnoux C, Quéméneur T, Ninet J et al (2015) Treatment of systemic necrotizing vasculitides in patients aged sixty-five years or older: results of a multicenter, open-label, randomized controlled trial of corticosteroid and cyclophosphamide-based induction therapy. Arthritis Rheumatol 67(4):1117–1127. https://doi.org/10.1002/art.39011CrossRefPubMed

12.

Furuta S, Iwamoto T, Nakajima H (2019) Update on eosinophilic granulomatosis with polyangiitis. Allergol Int 68(4):430–436. https://doi.org/10.1016/j.alit.2019.06.004CrossRefPubMed

13.

Almaani S, Fussner LA, Brodsky S, Meara AS, Jayne D (2021) ANCA-associated vasculitis: an update. J Clin Med 10(7). https://doi.org/10.3390/jcm10071446

14.

Watts RA, Scott DG (2012) ANCA vasculitis: to lump or split? Why we should study MPA and GPA separately. Rheumatology (Oxford) 51(12):2115–2117. https://doi.org/10.1093/rheumatology/kes230CrossRef

15.

Leavitt RY, Fauci AS, Bloch DA, Michel BA, Hunder GG, Arend WP, Calabrese LH, Fries JF, Lie JT, Lightfoot RW Jr et al (1990) The American College of Rheumatology 1990 criteria for the classification of Wegener’s granulomatosis. Arthritis Rheum 33(8):1101–1107. https://doi.org/10.1002/art.1780330807CrossRefPubMed

16.

Watts R, Lane S, Hanslik T, Hauser T, Hellmich B, Koldingsnes W, Mahr A, Segelmark M, Cohen-Tervaert JW, Scott D (2007) Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies. Ann Rheum Dis 66(2):222–227. https://doi.org/10.1136/ard.2006.054593CrossRefPubMed

17.

Jennette JC, Falk RJ, Bacon PA et al (2013) 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 65(1):1–11. https://doi.org/10.1002/art.37715CrossRefPubMed

18.

Bossuyt X, Cohen Tervaert JW, Arimura Y et al (2017) Position paper: revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis. Nat Rev Rheumatol 13(11):683–692. https://doi.org/10.1038/nrrheum.2017.140CrossRefPubMed

19.

Mukhtyar C, Hellmich B, Jayne D, Flossmann O, Luqmani R (2006) Remission in antineutrophil cytoplasmic antibody-associated systemic vasculitis. Clin Exp Rheumatol 24(6 Suppl 43):S-93-98

20.

Ahn SS, Yoon T, Park YB, Prendecki M, Bhangal G, McAdoo SP, Lee SW (2021) Serum chitinase-3-like 1 protein is a useful biomarker to assess disease activity in ANCA-associated vasculitis: an observational study. Arthritis Res Ther 23(1):77. https://doi.org/10.1186/s13075-021-02467-1CrossRefPubMedPubMedCentral

21.

Stone JH, Merkel PA, Spiera R et al (2010) Rituximab versus cyclophosphamide for ANCA-associated vasculitis. N Engl J Med 363(3):221–232. https://doi.org/10.1056/NEJMoa0909905CrossRefPubMedPubMedCentral

22.

Merkel PA, Aydin SZ, Boers M, Direskeneli H, Herlyn K, Seo P, Suppiah R, Tomasson G, Luqmani RA (2011) The OMERACT core set of outcome measures for use in clinical trials of ANCA-associated vasculitis. J Rheumatol 38(7):1480–1486. https://doi.org/10.3899/jrheum.110276CrossRefPubMedPubMedCentral

23.

Akoglu H (2018) User’s guide to correlation coefficients. Turk J Emerg Med 18(3):91–93. https://doi.org/10.1016/j.tjem.2018.08.001CrossRefPubMedPubMedCentral

24.

Tan JA, Dehghan N, Chen W, Xie H, Esdaile JM, Avina-Zubieta JA (2017) Mortality in ANCA-associated vasculitis: ameta-analysis of observational studies. Ann Rheum Dis 76(9):1566–1574. https://doi.org/10.1136/annrheumdis-2016-210942CrossRefPubMed

25.

Binda V, Moroni G, Messa P (2018) ANCA-associated vasculitis with renal involvement. J Nephrol 31(2):197–208. https://doi.org/10.1007/s40620-017-0412-zCrossRefPubMed

26.

Salama AD (2020) Relapse in anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis. Kidney Int Rep 5(1):7–12. https://doi.org/10.1016/j.ekir.2019.10.005CrossRefPubMed

27.

Westman K, Flossmann O, Gregorini G (2015) The long-term outcomes of systemic vasculitis. Nephrol Dial Transplant 30(Suppl 1):i60-66. https://doi.org/10.1093/ndt/gfu392CrossRefPubMed

28.

Solans-Laqué R, Rodriguez-Carballeira M, Rios-Blanco JJ et al (2020) Comparison of the Birmingham Vasculitis Activity Score and the Five-Factor Score to assess survival in antineutrophil cytoplasmic antibody-associated vasculitis: a study of 550 patients from Spain (REVAS Registry). Arthritis Care Res (Hoboken) 72(7):1001–1010. https://doi.org/10.1002/acr.23912CrossRef

Titel: BVAS version 3 and BVAS/GPA: standing on the same line?
verfasst von: Sung Soo Ahn
Jang Woo Ha
Yong-Beom Park
Sang-Won Lee
Publikationsdatum: 09.07.2022
Verlag: Springer International Publishing
Erschienen in: Clinical Rheumatology / Ausgabe 11/2022
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-022-06267-z

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

„Überwältigende“ Evidenz für Tripeltherapie beim metastasierten Prostata-Ca.

22.05.2024 Prostatakarzinom Nachrichten

Patienten mit metastasiertem hormonsensitivem Prostatakarzinom sollten nicht mehr mit einer alleinigen Androgendeprivationstherapie (ADT) behandelt werden, mahnt ein US-Team nach Sichtung der aktuellen Datenlage. Mit einer Tripeltherapie haben die Betroffenen offenbar die besten Überlebenschancen.

So sicher sind Tattoos: Neue Daten zur Risikobewertung

22.05.2024 Melanom Nachrichten

Das größte medizinische Problem bei Tattoos bleiben allergische Reaktionen. Melanome werden dadurch offensichtlich nicht gefördert, die Farbpigmente könnten aber andere Tumoren begünstigen.

CAR-M-Zellen: Warten auf das große Fressen

22.05.2024 Onkologische Immuntherapie Nachrichten

Auch myeloide Immunzellen lassen sich mit chimären Antigenrezeptoren gegen Tumoren ausstatten. Solche CAR-Fresszell-Therapien werden jetzt für solide Tumoren entwickelt. Künftig soll dieser Prozess nicht mehr ex vivo, sondern per mRNA im Körper der Betroffenen erfolgen.

Frühzeitige HbA1c-Kontrolle macht sich lebenslang bemerkbar

22.05.2024 Typ-2-Diabetes Nachrichten

Menschen mit Typ-2-Diabetes von Anfang an intensiv BZ-senkend zu behandeln, wirkt sich positiv auf Komplikationen und Mortalität aus – und das offenbar lebenslang, wie eine weitere Nachfolgeuntersuchung der UKPD-Studie nahelegt.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Introduction/objectives

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2022

The clinical pattern differentiates ANCA-positive infective endocarditis patients from ANCA-associated vasculitis patients: a 23 years’ retrospective cohort study in China and follow-ups

Autoimmune/autoinflammatory syndrome induced by adjuvants: a focus on silicone

Role of macrophage-associated chemokines in the assessment of initial axial spondyloarthritis

Correction to: Rare mutations in NLRP3 and NLRP12 associated with familial cold autoinflammatory syndrome: two Chinese pedigrees

The role of MBL, PCT, CRP, neutrophil–lymphocyte ratio, and platelet lymphocyte ratio in differentiating infections from flares in lupus