1. Treatment and its side effects in ANCA-associated vasculitides - Study based on POLVAS registry data.
- Author
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Biedroń G, Włudarczyk A, Wawrzycka-Adamczyk K, Wójcik K, Sznajd J, Zdrojewski Z, Masiak A, Czuszyńska Z, Majdan M, Jeleniewicz R, Klinger M, Jakuszko K, Rowaiye OO, Brzosko M, Brzosko I, Dębska-Ślizień A, Storoniak H, Tłustochowicz W, Kur-Zalewska J, Wisłowska M, Madej M, Hawrot-Kawecka A, Głuszko P, Kucharz EJ, Musiał J, and Szczeklik W
- Subjects
- Adult, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis pathology, Azathioprine adverse effects, Cyclophosphamide adverse effects, Drug Therapy, Combination, Drug-Related Side Effects and Adverse Reactions epidemiology, Drug-Related Side Effects and Adverse Reactions etiology, Female, Follow-Up Studies, Glucocorticoids adverse effects, Humans, Male, Methotrexate adverse effects, Middle Aged, Poland epidemiology, Prognosis, Retrospective Studies, Rituximab adverse effects, Survival Rate, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis drug therapy, Drug-Related Side Effects and Adverse Reactions diagnosis, Immunosuppressive Agents adverse effects, Registries statistics & numerical data
- Abstract
Purpose: The aim of this study is to present the treatment modalities and associated side effects in a Polish nation-wide ANCA-associated vasculitides (AAV) patients' cohort., Materials and Methods: Retrospective analysis of patients diagnosed with AAV between 1990 and 2016, included in the POLVAS registry was performed. Standard descriptive statistic methods were used with an emphasis on the treatment modalities., Results: There were 625 patients diagnosed with AAV included in this study: 417 cases of granulomatosis with polyangiitis (GPA; 66.7%), 106 cases of microscopic polyangiitis (MPA; 17.0%) and 102 cases of eosinophilic granulomatosis with polyangiitis (EGPA; 16.3%). The mean age at the date of diagnosis was 50.4 (±15.7) years and the median observational period amounted to 4.0 (2.0-8.0) years. Glucocorticosteroids (GCs) were the medicaments most frequently used for remission induction (593/622; 95.3%), followed by cyclophosphamide (487/622; 78.3%), rituximab (44/622; 7.1%), and methotrexate (39/622; 6.3%). GCs were also most frequently administered for maintenance therapy (499/592; 84.3%), followed by azathioprine (224/592; 37.8%), methotrexate (136/592; 23.0%) and mycophenolate mofetil (99/592; 16.7%). The median cumulative doses of cyclophosphamide and rituximab equalled 7.99 g (4.18-14.0) and 2000 mg (1500-2800), respectively. The most commonly observed adverse events included: infections - 214/551 cases (38.8%), which were associated with the time of observation (OR = 1.05; 95% CI 1.01-1.10), the use of GCs intravenous pulses (OR = 2.76; 95% CI 1.68-4.54) and need for haemodialysis (OR = 1.73; 95% CI 1.10-2.71)., Conclusions: Polish patients with AAV were predominantly treated according to appropriate guidelines. The most frequent adverse events were typical for usually administered immunosuppressive treatment., Competing Interests: Declaration of competing interest The authors declare no conflict of interests., (Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2020
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