Influence of smoking on disease activity and prognosis of ANCA-associated vasculitis: a retrospective cohort study

Patel, Agastya; Masiak, Anna; Joshi, Sanyukta; Ziętkiewicz, Marcin; Zdrojewski, Zbigniew

doi:10.20452/pamw.16478

Cited by 2 publications

(1 citation statement)

References 9 publications

(10 reference statements)

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“…[27] Numerous studies have confirmed the impact of smoking on cardiovascular and lung diseases, consistent with established knowledge. [28][29][30][31][32] Moreover, Patel et al [33] found that smoking constitutes an AAV-independent risk factor for patients' prognosis, correlating with heightened disease activity. Alternatively, it is plausible that cigarette smoking heightens the probability of AAV occurrence, mediated by its influence on oxidative stress and endothelial detriment.…”

Section: Discussionmentioning

confidence: 99%

Development of a novel predictive model for interstitial lung disease in ANCA-associated vasculitis prognostications within the Chinese population

Fan,

Li,

Wang

et al. 2024

Medicine

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Antineutrophil cytoplasmic antibody vasculitis-associated interstitial lung disease (AAV-ILD) is a potentially life-threatening disease. However, very little research has been done on the condition’s mortality risk. Hence, our objective is to find out the factors influencing the prognosis of AAV-ILD and employ these findings to create a nomogram model. Patients with AAV-ILD who received treatment at the First Affiliated Hospital of Zhengzhou University during the period from March 1, 2011, to April 1, 2022 were selected for this research. The development of nomogram entailed a synergistic integration of univariate, Lasso, and multivariate Cox regression analyses. Internal validation ensued through bootstrap techniques involving 1000 re-sampling iterations. Discrimination and calibration were assessed utilizing Harrell’s C-index, receiver operating characteristic (ROC) curve, and calibration curve. Model performance was evaluated through integrated discrimination improvement (IDI), net reclassification improvement (NRI), and likelihood ratio test. The net benefit of the model was evaluated using decision curve analysis (DCA). A cohort comprising 192 patients was enrolled for analysis. Throughout observation period, 32.29% of the population died. Key factors such as cardiac involvement, albumin, smoking history, and age displayed substantial prognostic relevance in AAV-ILD. These factors were incorporated to craft a predictive nomogram. Impressively, the model exhibited robust performance, boasting a Harrell’s C index of 0.826 and an AUC of 0.940 (95% CI 0.904–0.976). The calibration curves depicted a high degree of harmony between predicted outcomes and actual observations. Significantly enhancing discriminative ability compared to the ILD-GAP model, the nomogram was validated through the IDI, NRI, and likelihood ratio test. DCA underscored the superior predictive value of the predictive model over the ILD-GAP model. The internal validation further affirmed this efficacy, with a mean Harrell’s C-index of 0.815 for the predictive model. The nomogram model can be employed to predict the prognosis of patients with AAV-ILD. Moreover, the model performance is satisfactory. In the future, external datasets could be utilized for external validation.

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Section: Discussionmentioning

confidence: 99%

Development of a novel predictive model for interstitial lung disease in ANCA-associated vasculitis prognostications within the Chinese population

Fan,

Li,

Wang

et al. 2024

Medicine

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Granulomatosis with polyangiitis: clinical characteristics and updates in diagnosis

Potentas-Policewicz,

Fijolek

2024

Front. Med.

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Granulomatosis with polyangiitis (GPA) is a rare systemic disease characterized by granulomatous inflammation of the respiratory tract and necrotizing vasculitis of small and medium vessels often associated with the production of anti-neutrophil cytoplasmic antibodies (ANCA) directed mainly against leukocyte proteinase 3 (PR3). Usually, it involves upper airways, lungs, and kidneys, however any organ may be affected. The diagnosis is based on clinical, radiological, and serological findings. Biopsies, although strongly recommended, are not always feasible and often provides non-specific features. ANCA plays a crucial role in the diagnosis of GPA; nevertheless, ANCA detection is not a substitute for biopsy, which plays an important role in suspected cases, particularly when histological confirmation cannot be obtained. Significant advances have been made in classification criteria and phenotyping of the disease, particularly in determining the nuances between PR3-ANCA and myeloperoxidase (MPO)-ANCA vasculitis. This has led to better characterization of patients and the development of targeted treatment in the future. In addition, better identification of cytokine and immunological profiles may result in immuno-phenotyping becoming a new approach to identify patients with ANCA-associated vasculitis (AAV). Due to the chronic relapsing–remitting nature, strict follow-up of GPA is necessary to provide appropriate management. The search for the accurate marker of disease activity and to predict relapse is still ongoing and no predictor has been found to reliably guide therapeutic decision-making.

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Influence of smoking on disease activity and prognosis of ANCA-associated vasculitis: a retrospective cohort study

Cited by 2 publications

References 9 publications

Development of a novel predictive model for interstitial lung disease in ANCA-associated vasculitis prognostications within the Chinese population

Development of a novel predictive model for interstitial lung disease in ANCA-associated vasculitis prognostications within the Chinese population

Granulomatosis with polyangiitis: clinical characteristics and updates in diagnosis

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