Vasculitis & polymyalgia rheumatica
Large-vessel involvement in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis: A multicenter case-control study
Authors' conclusion
Regardless of distinctions based on vessel size, clinicians should consider LVI as a potential manifestation of AAV, with the aorta commonly affected. The risk of developing LVI appears to be greater for clinical phenotypes of AAV with neurological involvement.
Study context
- Population
- Patients with AAV (GPA n = 20, MPA n = 6) and large-vessel involvement; mean age 56.0 ± 17.1 years, 58% men
- Participants
- 26 cases
- Comparison
- AAV with large-vessel involvement (LVI) vs matched AAV controls without LVI
- LVIn = 26
- Outcome
- Characteristics of LVI
Methodological detailsmulticentre, 1:2 matched for age, sex and AAV type
- Multicentre
- 1:2 matched for age, sex and AAV type
Main finding
As reported in the abstract
- Aorta affected
- n = 18; 69 %
- Supra-aortic trunks affected
- n = 9; 35 %
- Lower-limb arteries affected
- n = 5; 19 %
- Mesenteric arteries affected
- n = 5; 19 %
- Renal arteries affected
- n = 4; 15 %
- Upper-limb arteries affected
- n = 2; 8 %
- Imaging: wall thickening
- n = 10; 38 %
- Imaging: perivascular inflammation
- n = 8; 31 %
- Imaging: aneurysms
- n = 5; 19 %
- Imaging: stenosis
- n = 4; 15 %
Observational data: associations, not effects.
Further findings
| Outcome | OR (95 % CI) | P value | |
|---|---|---|---|
| Association of LVI with neurological manifestations | 3.23 (1.11–10.01) | P = 0.03 | |
| Association of LVI with cardiovascular risk factors | 0.70 (0.23–2.21) | P = 0.60 | |
| Association of LVI with AAV relapse | 2.01 (0.70–5.88) | P = 0.16 | |
| 0.050.21520Odds ratio (log scale) |
Treatment of LVI
- Corticosteroids
- All patients
- Plus an immunosuppressant
- 24 (92 %)
- Cyclophosphamide
- n = 10, 38 %
- Rituximab
- n = 9, 35 %
Original publication
Large-vessel involvement in ANCA-associated vasculitis: A multicenter case-control study. Semin Arthritis Rheum. Published 21 May 2024. doi:10.
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