Vasculitis & polymyalgia rheumatica
Characteristics and outcome of ANCA-associated vasculitides induced by anti-thyroid drugs: a multicentre retrospective case-control study
Authors' conclusion
ATD-induced AAV were mainly MPA with MPO-ANCA, but double MPO- and PR3-ANCA positivity was frequent. The most common manifestations were skin and musculoskeletal manifestations. ATD-induced MPA were less severe and showed a lower risk of relapse than primary MPA.
Study context
- Population
- Patients with ANCA-associated vasculitis (AAV) induced by anti-thyroid drugs, multicentre45 anti-thyroid drugs (ATD)-induced AAV, 24 microscopic polyangiitis (MPA)
- Participants
- 24 vs 96
- Comparison
- ATD-induced MPA vs matched primary MPA
- ATD-induced MPAn = 24
- Primary MPAn = 96reference
- Outcome
- Characteristics of ATD-induced AAV
Methodological detailsmulticentre, matched by gender and year of diagnosis (four controls per case)
- Multicentre
- Matched by gender and year of diagnosis (four controls per case)
Main finding
As reported in the abstract
- ANCA positive
- 44 patients (98%)
- MPO-ANCA
- 21 (47%)
- PR3-ANCA
- 6 (13%)
- Double positive myeloperoxidase (MPO)- and PR3-ANCA
- 15 (33%)
- Skin involvement
- 64%
- Arthralgia
- 51%
- Glomerulonephritis
- 20%
- ATD discontinued
- 98%
- Remission after ATD discontinuation alone
- 7 (16%)
- Remission with GC plus RTX
- 11 (30%)
- Remission with GC plus CYC
- 4 (11%)
- ATD reintroduced, without subsequent relapse
- 7 (16%)
Observational data: associations, not effects.
Further findings
Age at diagnosis
P < 0.001
Cutaneous involvement
P = 0.007
Kidney involvement
P = 0.02
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| Relapse | 0.07 (0.01–0.65) | P = 0.019 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
Original publication
Characteristics and outcome of ANCA-associated vasculitides induced by anti-thyroid drugs: a multicentre retrospective case-control study. Rheumatology (Oxford). Published 24 June 2023. doi:10.
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