Relapse in patients with ANCA-associated vasculitis: A cohort study from a centre for rheumatic diseases in Colombia

• Published in: Revista Colombiana de Reumatología (English Edition) 2024-07, Vol.31 (3), p.318-326
• Main Authors: Romero-Millán, Ana María, Arango-Vieira, Andrés, Ibarra-Burgos, Jaime Andrés, Mesa-Maya, Maria Antonia, Orrego-Garay, María José, Gómez-Maya, Santiago, Giraldo-Hinestroza, Tomás, Torres-Saavedra, Fabio, Rojas-Gualdrón, Diego Fernando, Díaz-Coronado, Juan Camilo
• Format: Article
• Language: English
• Subjects: ANCA-associated vasculitis; Autoimmune diseases; Colombia; Enfermedades autoinmunes; Recaída; Relapse; Vasculitis asociadas a ANCA
• ISSN: 2444-4405; 2444-4405
• DOI: 10.1016/j.rcreue.2024.08.002

Relapses are common in patients with ANCA-associated vasculitis (AAV), which results in a significant burden of morbidity, mortality, impact on quality of life, disability, and cost. However, evidence in the Colombian population is scarce. The objective of this study was to estimate the relapse-free survival during the first year and describe clinical and serological variables of patients with AAV in a specialized centre for rheumatic diseases in Colombia. A retrospective follow-up study was conducted on a cohort based on medical records of patients over 18 years old with confirmed diagnosis of AAV by the treating rheumatologist and who had achieved remission. Information on AAV relapse and clinical, immunoserological, and treatment-related characteristics was extracted. The relapse-free survival function during the first year was estimated. A total of 56 patients were included, 69.9% of whom were women, with a median age of 60 (IQR=48−63). According to the clinical phenotype, 64.3% were classified as granulomatosis with polyangiitis (GPA), 23.2% as microscopic polyangiitis (MPA), and 12.5% as eosinophilic granulomatosis with polyangiitis (EGPA). According to the European Vasculitis Study Group (EUVAS) classification, 39.3% had generalized AAV at debut, 23.2% had localized AAV, 21.4% had severe renal AAV, and 16.1% had systemic AAV. The median Five Factor Score (FFS) was 1 (IQR=0−2). The cumulative relapse-free survival at one year was 82.2%. The relapse-free survival observed in this cohort was similar to other reports in clinical studies and AAV registries. Las recaídas son comunes en pacientes con vasculitis asociadas a ANCA (VAA), lo cual conlleva una carga significativa en morbimortalidad, impacto en calidad de vida, discapacidad y costo. No obstante, se cuenta con poca evidencia en población colombiana. El objetivo de este estudio fue estimar la supervivencia libre de recaída durante el primer año en pacientes con VAA en un centro especializado en enfermedades reumatológicas en Colombia y describir las características clínicas y serológicas en esta población. Estudio de seguimiento retrospectivo a una cohorte basado en los registros médicos de pacientes mayores de 18 años con diagnóstico confirmado de VAA por el reumatólogo tratante y que habían alcanzado la remisión. Se extrajo información sobre recaída de VAA y sobre las características clínicas, inmunoserológicas y relacionadas con el tratamiento farmacológico. Se estimó la función de supervivenci