Vasculitis & polymyalgia rheumatica
Granulomatosis with polyangiitis with and without antineutrophil cytoplasmic antibodies: a case-control study
Authors' conclusion
Patients with ANCA-negative GPA have milder disease and a lower frequency of relapse than those with ANCA-positive GPA.
Study context
- Population
- Patients with granulomatosis with polyangiitis (GPA), single centre, 1 January 1996 to 31 December 2015
- Comparison
- ANCA-negative vs ANCA-positive GPA
- ANCA-negative GPAn = 110
- Outcome
- Disease severity (BVAS/WG)
Methodological detailssingle-centre, sex and age matched, case-crossover study of seroconverters
- Single-centre
- Sex and age matched
- Case-crossover study of seroconverters
Main finding
As reported in the abstract
ANCA-negative GPA
2
ANCA-positive GPA
6
P < 0.001
Observational data: associations, not effects.
Further findings
Relapse over 60 months
P = 0.009
| Outcome | P value |
|---|---|
| Relapse over 60 monthsShorter time to event in ANCA-positive GPA | P = 0.043 |
Organ manifestations
- Mucous membranous/eye manifestations more frequent in ANCA-negative GPA
- General symptoms, pulmonary and renal involvement more frequent in ANCA-positive GPA
Seroconversion to ANCA-positive during follow-up (case-crossover)
- Seroconverters (n = 16): higher mean BVAS/WG at diagnosis
- P < 0.001
- Seroconverters: increased incidence of relapses after seroconversion
- P = 0.004
- Necrotizing granulomatous inflammation on biopsy: risk factor for seroconversion
Relapse risk factors
- General manifestations, BMI > 30kg/m² and necrotizing granulomatous inflammation: more likely to relapse
Original publication
Granulomatosis with polyangiitis with and without antineutrophil cytoplasmic antibodies: a case-control study. Rheumatology (Oxford). Published 27 July 2024. doi:10.
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