Vasculitis & polymyalgia rheumatica
Remission and Low Disease Activity in Granulomatosis With Polyangiitis and Microscopic Polyangiitis: Prevalence and Impact on Damage Accrual
Authors' conclusion
More than 60% of patients with GPA/MPA achieved prolonged remission, which was associated with better long-term outcomes. In contrast, prolonged LDAS correlated with increased damage accrual and was not a sufficient treatment target.
Study context
- Population
- Patients with granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) followed for ≥5 years in 2 centres (128 GPA, 39 MPA; mean ± SD age 51.0 ± 16.7 years)
- Participants
- 167 patients
- Exposure
- Levels of disease activity and 5-year damage accrual
- Complete remissionn = 10
- Clinical remission off therapy (CROffT)n = 6
- Clinical remission on therapy (CROnT)n = 89
- Low disease activity state (LDAS)n = 42
- Never LDASn = 20
- Outcome
- Prevalence of prolonged (≥2 consecutive years) remission or LDAS, and damage accrual (VDI)
- Follow-up
- 5 years
Methodological details2 centres, ≥5 years follow-up, multivariate analysis
- 2 centres
- ≥5 years follow-up
- Multivariate analysis
Main finding
As reported in the abstract
Prolonged remission/LDAS achieved during 5-year follow-up
Observational data: associations, not effects.
Further findings
Mean
| Outcome | No prolonged remission | Prolonged remission | P value |
|---|---|---|---|
| VDI score at 5 years, by prolonged remission | 3.7 (SD 2.0) | 2.2 (SD 1.9) | P < 0.0001 |
Vasculitis Damage Index (VDI) score at 5 years, by prolonged remission
- VDI at 5 years progressively worsened with increasing levels of disease activity targets (complete remission, CROffT, CROnT, LDAS)
Negative predictors of prolonged remission (multivariate)
- Baseline ear, nose and throat involvement
- P = 0.006
- Baseline lung involvement
- P = 0.047
Original publication
Remission and Low Disease Activity in Granulomatosis With Polyangiitis and Microscopic Polyangiitis: Prevalence and Impact on Damage Accrual. Arthritis Care Res (Hoboken). Published 21 December 2022. doi:10.
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