Disease flares, damage accrual and survival in ANCA-associated vasculitis in Western Australia

Paramalingam, Shereen; Raymond, Warren; Sharma, C. S.; Dogra, Gursharan; McLean‐Tooke, Andrew; Nossent, Johannes C.

doi:10.4172/1758-4272.1000221

Cited by 6 publications

(5 citation statements)

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“…Our overall disease incidence was higher than that described in central Sydney (6 per million/year, 95% CI: 1.9-13.9) 5 ; however, it was lower than that reported in Melbourne between 2009 and 2011 (22 per million/year). 9 Our estimate was similar to the incidence in urban WA (10.1 per million/year, 95% CI: 7.6-13.8) 8 and the ACT (10.5 per million/year). 6 Methodological differences may explain why a higher incidence of AAV was not observed in our rural/regional cohort.…”

Section: Discussionsupporting

confidence: 73%

“…4 Prior Australian studies described the incidence of AAV in New South Wales (NSW), 5,6 South Australia (SA), 7 the Australian Capital Territory (ACT) 6 and Western Australia (WA). 8 These articles report an overall incidence of AAV ranging from 6 to 17 cases per million/year. The only incidence data currently available for Victoria are a brief letter published by Gujadhur et al in 2012.…”

Section: Introductionmentioning

confidence: 99%

“…Local epidemiological data are valuable for AAV as the disease incidence varies worldwide 4 . Prior Australian studies described the incidence of AAV in New South Wales (NSW), 5,6 South Australia (SA), 7 the Australian Capital Territory (ACT) 6 and Western Australia (WA) 8 . These articles report an overall incidence of AAV ranging from 6 to 17 cases per million/year.…”

Section: Introductionmentioning

confidence: 99%

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Incidence of anti‐neutrophil cytoplasmic antibody‐associated renal vasculitis: a retrospective study in rural and regional Victoria, Australia

Oakman,

Bach,

Ong

2023

Internal Medicine Journal

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BackgroundThe epidemiology of anti‐neutrophil cytoplasmic antibody (ANCA)‐associated vasculitis (AAV) varies worldwide. Previous Australian studies described a higher incidence of AAV in rural areas; however, this has not yet been investigated in Victoria.AimsTo calculate the incidence of AAV in rural and regional Victoria and characterise the demographics and clinical outcomes of this cohort.MethodsWe performed a retrospective review of patients with newly diagnosed AAV confirmed on renal biopsy at Bendigo Health between 2013 and 2021. Cases were classified according to the 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology criteria. Local disease incidence was calculated using Estimated Resident Population data for our catchment, the Loddon Mallee region.ResultsTwenty‐eight cases of new AAV were identified; 17 were classified as microscopic polyangiitis (MPA) and the remainder as granulomatosis with polyangiitis (GPA). The median age at diagnosis was 68 years (interquartile range (IQR): 59–77). The incidence per million person‐years was 9.3 for AAV overall (95% CI: 6.2–13.5), 5.7 for MPA (95% CI: 3.3–9.1) and 3.7 for GPA (95% CI: 1.8–6.6). With a median follow‐up time of 3.3 years (IQR: 1.9–5.6), one‐quarter of patients relapsed (n = 7, 25%), and six required ongoing renal‐replacement therapy (21%).ConclusionsThe calculated incidence of AAV in rural and regional Victoria is not higher than the reported incidence in most urban Australian cohorts. This study may underestimate the true local disease incidence as only patients with renal vasculitis were included.

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Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incidence of anti‐neutrophil cytoplasmic antibody‐associated renal vasculitis: a retrospective study in rural and regional Victoria, Australia

Oakman,

Bach,

Ong

2023

Internal Medicine Journal

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“…This contrasts with data published by other investigators in which male sex has been associated with poorer outcomes 12,30,41 . As to ANCA status, there is no uniformity in the literature, with some studies presenting similar findings to ours 12,22,23,26,27,31,40,41 and others finding ANCA-MPO (HR, 2.12; 95% CI, 1.08–4.17; p = 0.03) and ANCA-PR3 to be associated with higher mortality (relative risk, 9.32; p = 0.004) 30,42 …”

Section: Discussioncontrasting

confidence: 64%

Survival in ANCA-Associated Vasculitides in a Peruvian Center

et al. 2020

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The aim of this study was to identify demographic and clinical risk factors for mortality in patients with antineutrophil cytoplasmic antibodies-associated vasculitides (AAVs) in a Peruvian tertiary referral hospital.Methods: Medical records of patients with AAVaccording to classification criteria or diagnosed by an experienced rheumatologist, covering the period between January 1990 and December 2018, were reviewed. Granulomatosis with polyangiitis, microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis, and renal-limited vasculitis were included. Potential predictors of mortality were demographic factors, clinical manifestations, antineutrophil cytoplasmic antibodies status, diagnosis, disease categorization, the 2009 Five Factor Score (FFS), and treatment. Cox regression models were used to determine the risk factors for mortality. Univariable and multivariable analyses using a backward selection method were performed.Results: One hundred ninety-six patients were included; female-to-male ratio was 2:1. The median (interquartile range) age at diagnosis and follow-up were 60.0 (51.0-68.0) and 4.8 (1.3-11.6) years, respectively. One hundred forty-eight patients (75.5%) had microscopic polyangiitis, 37 (18.9%) granulomatosis with polyangiitis, 5 (2.6%) eosinophilic granulomatosis with polyangiitis, and 6 (3.0%) renal-limited vasculitis. Overall survival rates at 1, 5, and 10 years were 83.4%, 68.2%, and 51.7%, respectively. Ocular involvement was protective (hazards ratio [HR], 0.

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“…Although this represents real‐world clinician‐based diagnoses mandatorily audited by clinical coders, they are not validated against classification criteria through case‐note review. A previous study from WA using the same discharge codes, however, reported a sensitivity of 91% for AAV diagnosis based on the European Medicines Agency classification algorithm (44).…”

Section: Discussionmentioning

confidence: 99%

Cancer in Anti‐Neutrophil Cytoplasm Antibody‐Associated Vasculitis and Polyarteritis Nodosa in Australia: A Population‐Based Study

Tieu

Lester

Raymond

et al. 2021

ACR Open Rheumatology

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Objective. The study objective was to compare incident cancer rates among patients with anti-neutrophil cytoplasm antibody-associated vasculitis (AAV) and polyarteritis nodosa (PAN) in Western Australia (WA) with the general population and perform time-varying analyses to identify periods with greatest excess cancers.Methods. Administrative health data from patients hospitalized with incident AAV/PAN from 1980 to 2014 were linked to the WA cancer registry, which holds compulsorily reported cancer data (excluding skin squamous cell and basal cell carcinomas). Incident cancer rates in patients with AAV/PAN were compared with age-, sex-, and calendar-year-matched WA population rates.Results. Patients with AAV/PAN had higher overall rates of incident cancer compared with the matched population (standardized incidence ratio [SIR], 1.74; 95% confidence interval [CI], 1.42-2.10). In subgroup analyses, incident cancer rates in patients with granulomatosis with polyangiitis/eosinophilic granulomatosis with polyangiitis were approximately double the general population (SIR, 2.21; 95% CI, 1.73-2.78) but similar to the general population in patients with microscopic polyangiitis/PAN (SIR, 1.21; 95% CI, 0.85-1.68). Patients with AAV/PAN had higher rates of genitourinary, skin, hematological, and lung cancers. Excess rates of hematological and lung cancers peaked early after diagnosis, whereas excess skin and genitourinary cancer rates peaked at 5 and 10 years, respectively.Conclusion. This study highlights the importance of long-term cancer surveillance in patients with AAV/PAN and defines time frames of excess risk for specific cancers, which may help inform guidance on cancer screening. Furthermore, it indicates the need for skin surveillance for melanoma in addition to nonmelanoma skin cancers in patients who have greater environmental ultraviolet exposure, such as in Australia.

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Disease flares, damage accrual and survival in ANCA-associated vasculitis in Western Australia

Cited by 6 publications

References 0 publications

Incidence of anti‐neutrophil cytoplasmic antibody‐associated renal vasculitis: a retrospective study in rural and regional Victoria, Australia

Incidence of anti‐neutrophil cytoplasmic antibody‐associated renal vasculitis: a retrospective study in rural and regional Victoria, Australia

Survival in ANCA-Associated Vasculitides in a Peruvian Center

Cancer in Anti‐Neutrophil Cytoplasm Antibody‐Associated Vasculitis and Polyarteritis Nodosa in Australia: A Population‐Based Study

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