Association between age at disease onset of anti-neutrophil cytoplasmic antibody–associated vasculitis and clinical presentation and short-term outcomes

作者：Sara Monti, Anthea Craven, Catherine Klersy, Carlomaurizio Montecucco, Roberto Caporali, Richard A. Watts, Peter A. Merkel, Raashid Luqmani, DCVAS Collaborators, Katerina Achilleos, Matthew D. Adler, Marco A. Alba, Marco A. Alba, Daniel Albert, Fatma Alıbaz-Öner, Paul Allcoat, Koichi Amano, M. Amarasuriya, Naomi A. Amudala, Jacqueline Andrews, Amy M. Archer, Yoshihiro Arimura, Inoshi Atukorala, Elsa Azevedo, Shruti Bajad, Corisande Baldwin, Lillian J. Barra, Bo Baslund, Neil Basu, Mahire Baykal, Christoph Berger, Ewa Berglin, Emilio Besada, Mamta Bhardwaj, Antje Bischof, Daniël Blockmans, Janet Blood, Juliana Draibe, Sarah Brand, Mariana Brandão, Ian N Bruce, Amanda Butler, Leonard H. Calabrese, Daniel Camprubi Ferrer, Simon Carette, Diana Karina Delgado Carmona, Helga Ceunen, Kuntal Chakravarty, Peter T. Chapman, Zdeňka Chocová, Sharon A. Chung, Weiping Ci, María C. Cid, Tiffany Clark, Michael R. Clarkson, Felipe de Jesús Contreras-Rodríguez, Richard Conway, Kelly Cooke, Xavier Corbella Virós, Ana Cordeiro, Andreia Costa, Anthea Craven, Karen Culfear, Thomas Daikeler, Debashish Danda, Siddharth Das, Bhaskar Dasgupta, Alice M De Castro, Natasha Dehghan, Roni Devassy, Navjot Dhindsa, Andreas P. Diamantopoulos, Haner Di̇reskeneli̇, Hiroaki Dobashi, Juan Du, Maumer Durrani, Clive Edelsten, J. Eifert, Sallie Elhayek, Sunhoury Elsideeg, Tomomi Endo, Abdülsamet Erden, Burak Erer, Per Eriksson, Zeynep Ertürk, Georgina Espígol‐Frigolé, Mara Felicetti, Alaistair Ferraro, José M. Ferro, Aurore Fifi‐Mah, Luis Felipe Flores-Suárez, Oliver Floßmann, Deirdre Flynn, João Eurico Fonseca, Jayne Foot, Michelle Foote, Lindsy Forbess, Shouichi Fujimoto, Kazuhito Fukuoka, Carolina Furtado, Shunsuke Furuta, Angelo Gaffo, Phil Gallagher, Na Gao, Paul A. Gatenby, Nagui Gendi, Ruth Geraldes, Anneleen Gerits, Andrea Gioffredi, Luke Gomples, Anabela Susana de Sousa Gonçalves, Prisca Gondo, Anne Marie Graham, Rebecca Grainger, D. Gray, Peter C. Grayson, Laura Griffiths, Yanqiu Guo, Rajiva Gupta, Micael Gylling, Rula A. Hajj‐Ali, Nevin Hammam, Masayoshi Harigai, Lorraine Hartley, Janine Haslett, Alaa Jawad Hassan, Gülen Hatemi, Bernhard Hellmich, Liesbet Henckaerts, Jörg Henes, Joanna Hepburn, Vera Herd, Christoph Hess, Catherine Hill, Andrea Hinojosa‐Azaola, Junichi Hirahashi, Fumio Hirano, Alojzija Hočevar, Julia U. Holle, Nicole Hollinger, Sakae Homma, Theresa Howard, Rachel K. Hoyles, Zdenka Hrušková, Gayle Hutcheon, Maria Ignacak, Annette Igney-Oertel, Kei Ikeda, Noriko Ikegaya, Samyukta Jagadeesh, Jane Jaquith, David Jayne, Teresa Jewell, Colin Jones, Abhay Joshi, Umut Kalyoncu, Sevil Kamalı, Sanjeet Kamath, Kan Sow Lai, Shinya Kaname, S Kanchinadham, Ömer Karadağ, Miho Karube, Marek Kaszuba, Ramanjot Kaur, Tamihiro Kawakami, Soko Kawashima, Nader Khalidi, Asad Khan, Masao Kikuchi, Levent Kılıç, Makiko Kimura, Maria J. King, Sebastian Klapa, Rainer Klocke, Tatsuo Kobayashi, S Kobayashi, Yoshinori Komagata, Andreas Kronbichler, Paweł Kuczia, Mandal Santosh Kumar, Miho Kurosawa, Peter Lamprecht, Carol A. Langford, Peter Lanyon, Catherine Laversuch, Sang Jin Lee, Simona Leoni, Jing Li, Kimberly P. Liang, Patrick Liang, Hua Liao, L. Lee, Raashid Luqmani, Amanda Lyle, Matthew L. MacDonald, Sarah Mackie, Leah Madden, Malgorzata Magliano, Hirofumi Makino, Ashima Makol, Ritu Malaiya, Anshuman Malaviya, Ramesh Manthri, Federica Maritati, Ana Silva, Justin C. Mason, Cecilia Matara, Kazuo Matsui, Eric L. Matteson, Dawn McBride, Keith McCullough, Lucy McGeoch, John McLaren, Caitlin McMillian, Naval Mendiratta, Ajit Menon, Dimos Merinopoulos, Peter A. Merkel, Peter A. Merkel, Sandra Messier, Robert G. Micheletti, Karen Mills, Nataliya Milman, Masahiro Minoda, Ranjana W. Minz, Claudia Möck, Aladdin J Mohammad, Sergey Moiseev, Marta Moitinho, Eamonn Molloy, Paul A. Monach, Marian Montgomery, Frank Moosig, Manoosh Moradizadeh, Matthew D. Morgan, Ann W Morgan, Ann-Marie Morgan, Alice Muir, Chetan Mukhtyar, Antje Müller, Francesco Muratore, Eri Muso, Ritambhra Nada, Hiroshi Nakajima, Toshiki Nakajima, Hiroto Nakano, Anupapama Nandagudi, Thomas Neumann, Ying Fun Ng, Kooi Heng Ng, Estela L Nogueira, Nilesh Nolkha, Dan Nordström, Pavel Novikov, Asanka Nugaliyadde, John L O’Donnell, Jennifer O’Donoghue, Lorraine O’Neill, Edmond O’Riordan, Margaret Oatley, Koshu Okubo, Elena Oliva, Hideto Oshikawa, Yuichiro Ota, Roberto Padoan, Christian Pagnoux, Lili Pan, Kalliopi Panaritis, Jin Kyun Park, Sanjeev Patel, Pravin Patil, Giulia Pazzola, Adrian Peall, Fiona Pearce, Seval Pehlevan, Liliana Pereira, Tom Pettersson, Christian A. Pineau, Laura Pirilä, Bartłomiej Pogłódek, Cristina Ponte, Sergio Prieto‐González, Sangeetha R Priya, Bally Purewal, Silke Purschke, Jukka Putaala, Stefanie Quickert, Vicki Quincey, Subhra Raghuvanshi, Liza Rajasekhar, Dwarakanathan Ranganathan, Manish Rathi, David C. Rees, Frances Rees, Ulrike Renken, G. Restuccia, Rennie L. Rhee, Brian Rice, Diane M. Robins, Joanna Robson, Joanna Robson, Miguel Rodrigues, Vasco C. Romão, Žiga Rotar, Carlee Ruediger, Abraham Rutgers, Ana Laura Ferreira Sá, Maria João Saavedra, Ken‐ei Sada, Ilfita Sahbudin, Carlo Salvarani, Namneet Sandhu, Ernestina Santos, Yuji Sato, Valentin Sebastian Schäfer, Franco Schiavon, Wolfgang Schmidt, Mårten Segelmark, Amira A. Shahin, Aman Sharma, Julie Shotton, Cristiana J. Silva, Ora Singer, Goutham Sivasuthan, Susan Smolen, Xavier Solanich, Laura Soldevila Boixader, Yeong Wook Song, Jason Springer, Antoine G. Sreih, Antoine G Sreih, R.M. Srivastava, Lisa K. Stamp, Robert C. Stevens, Daniel Strbian, Keishi Sugino, Cord Sunderkötter, Ravi Suppiah, Katsuya Suzuki, Kazuo Suzuki, Zoltán Szekanecz, J Sznajd, Kirsi Taimen, Paul P. Tak, Tsutomu Takeuchi, Naoho Takizawa, Lilian Tames, Bee Eng Tan, Mototsugu TANAKA, Man Tang, Turgut Tatlisumak, Vladimı́r Tesař, Alan Thomas, Xinping Tian, K. Tokunaga, Enrico Tombetti, Matija Tomšič, Bahtiyar Toz, Tatsuo Tsukamoto, Shunya Uchida, Ali Ünal, Maria Letizia Urban, Joichi Usui, Augusto Vaglio, Srinivasan Venkatachalam, Erin Vermaak, Vishad Viswanath, Takashi Wada, Shrikant Wagh, Daniel J. Wallace, Giles Walters, Bastian Walz, Jin Wan, Tian Wang, Guochun Wang, Kenneth J. Warrington, Richard A. Watts, Katarzyna Wawrzycka‐Adamczyk, Praveen Weeratunga, Michael H. Weisman, Sugeesha Wickramasinghe, Mark M. Williams, Megan Williams, Krzysztof Wójcik, Laticia Woodruff, Theodoros Xenitidis, Hidehiro Yamada, Kunihiro Yamagata, Chee‐Seng Yee, Myeongjae Yoon, Kazuki Yoshida, Hajime Yoshifuji, Steven R. Ytterberg, Wako Yumura, Hania S. Zayed, Xiaofeng Zeng, Ming‐Hui Zhao, Anna Zugaj, Joanna Żuk · 发表于：Lara D. Veeken · 年份：2020 · DOI：10.1093/rheumatology/keaa215 · 被引用次数：39 · 研究领域：Vasculitis and related conditions、Otitis Media and Relapsing Polychondritis、Autoimmune and Inflammatory Disorders

OBJECTIVES: ANCA-associated vasculitis (AAV) can affect all age groups. We aimed to show that differences in disease presentation and 6 month outcome between younger- and older-onset patients are still incompletely understood. METHODS: We included patients enrolled in the Diagnostic and Classification Criteria for Primary Systemic Vasculitis (DCVAS) study between October 2010 and January 2017 with a diagnosis of AAV. We divided the population according to age at diagnosis: <65 years or ≥65 years. We adjusted associations for the type of AAV and the type of ANCA (anti-MPO, anti-PR3 or negative). RESULTS: A total of 1338 patients with AAV were included: 66% had disease onset at <65 years of age [female 50%; mean age 48.4 years (s.d. 12.6)] and 34% had disease onset at ≥65 years [female 54%; mean age 73.6 years (s.d. 6)]. ANCA (MPO) positivity was more frequent in the older group (48% vs 27%; P = 0.001). Younger patients had higher rates of musculoskeletal, cutaneous and ENT manifestations compared with older patients. Systemic, neurologic,cardiovascular involvement and worsening renal function were more frequent in the older-onset group. Damage accrual, measured with the Vasculitis Damage Index (VDI), was significantly higher in older patients, 12% of whom had a 6 month VDI ≥5, compared with 7% of younger patients (P = 0.01). Older age was an independent risk factor for early death within 6 months from diagnosis [hazard ratio 2.06 (95% CI 1.07, 3.97); P = 0.03]. CONCLUSION: Wit...