Long-Term Prognostic Factors in Patients With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A 15-Year Multicenter Retrospective Study

Liao, Qian-Qian; Ren, Ya-Fei; Zhu, Ke-Wei; Qin, Dong; Mo, Yan-Ju; Cong, Shan; Wu, Juan; Wang, Chunying; Cui, Xiao-Jiao; Xu, Hong-Zhen; Guo, Lin-Zheng; Zhang, Youyan; Song, Hai-Xia; Zhang, Wei; Yang, Zhe; Tang, Yan-Feng; Li, Zhuo-Jun; Xie, Zhou-Ni; Li, Limei; Wang, Huijuan; Zhou, Meng-Meng; Wei, Fang-Ning; Chen, Peng; Shi, Yuhong

doi:10.3389/fimmu.2022.913667

Cited by 17 publications

(5 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This analysis of a real-life Italian clinical setting focused on the most common AAV forms, namely GPA and MPA, reported to have a later clinical onset, respectively 45–65 years and 50–60 years compared to EGPA, which presents more commonly between 30 and 50 years [ 2 – 5 ]. In line with these trends, our GPA and MPA patients were aged approximately 57–58 years, in general comparable between the two disease forms [ 28 ]. In contrast with previous studies [ 8 ], our population showed a slightly female predominance, but some divergences in demographic and epidemiological data of AAV are expected among studies conducted on different ethnicities and geographical areas [ 8 , 9 ].…”

Section: Discussionsupporting

confidence: 73%

Profile, Healthcare Resource Consumption and Related Costs in ANCA-Associated Vasculitis Patients: A Real-World Analysis in Italy

Degli Esposti,

Dovizio,

Perrone

et al. 2023

Adv Ther

View full text Add to dashboard Cite

Introduction Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are rare autoimmune diseases triggering inflammation of small vessels. This real-world analysis was focused on the most common AAV forms, granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), to describe patients’ demographic and clinical characteristics, therapeutic management, disease progression, and the related economic burden. Methods A retrospective analysis was conducted on administrative databases of a representative sample of Italian healthcare entities, covering approximately 12 million residents. Between January 2010 and December 2020, adult GPA patients were identified by payment waiver code or hospitalization discharge diagnosis, and MPA patients by payment waiver code with or without hospitalization discharge diagnosis. Clinical outcomes were evaluated through AAV-related hospitalizations, renal failure onset, and mortality. Economic analysis included healthcare resource utilization deriving from drugs, hospitalizations, and outpatient specialist services. The related mean direct costs year/patient were also calculated in patients stratified by presence/absence of glucocorticoid therapy and type of inclusion criterion (hospitalization/payment waiver code). Results Overall, 859 AAV patients were divided into GPA ( n = 713; 83%) and MPA ( n = 146; 17%) cohorts. Outcome indicators highlighted a clinically worse phenotype associated with GPA compared to MPA. Cost analysis during follow-up showed tendentially increased expenditures in glucocorticoid-treated patients versus untreated (overall AAV: €8728 vs. €7911; GPA: €9292 vs. €9143; MPA: €5967 vs. €2390), mainly driven by drugs (AAV: €2404 vs. €874; GPA: €2510 vs. €878; MPA: €1881 vs. €854) and hospitalizations. Conclusion Among AAV forms, GPA resulted in a worse clinical picture, higher mortality, and increased costs. This is the first real-world pharmaco-economic analysis on AAV patients stratified by glucocorticoid use on disease management expenditures. In both GPA and MPA patients, glucocorticoid treatment resulted in higher healthcare costs, mostly attributable to medications, and then hospitalizations, confirming the clinical complexity and economic burden for management of patients with autoimmune diseases under chronic immunosuppression. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-023-02681-0.

show abstract

Section: Discussionsupporting

confidence: 73%

Profile, Healthcare Resource Consumption and Related Costs in ANCA-Associated Vasculitis Patients: A Real-World Analysis in Italy

Degli Esposti,

Dovizio,

Perrone

et al. 2023

Adv Ther

View full text Add to dashboard Cite

show abstract

“…In fact, liver involvement was proven to be related to the disease activity and to predict poor clinical outcomes. 9 In the present case, the patient did not comply with the treatment. He presented after two years with acute heart failure with a rapidly progressive fatal outcome.…”

Section: Discussioncontrasting

confidence: 50%

Case Report: An unusual presentation of granulomatosis with polyangiitis

et al. 2023

View full text Add to dashboard Cite

Aim: We are reporting a case of an unusual presentation of granulomatosis with polyangiitis (GPA) with liver involvement. Case presentation: A 45-year-old male patient presented with erythematous plaques on the face and bilateral nasal obstruction. On physical examination, the patient had a ring-shaped squamous plaque on the face. The laboratory findings revealed an accelerated erythrocyte sedimentation rate at 100 mm/h, an elevated C-reactive protein at 66 mg/L, hyper gamma globulinemia 16 g/L and an elevated alkaline phosphatase (twice the upper normal limit). The craniofacial and thoracoabdominal computed tomography (CT) -scans showed ethmoid and maxillary sinusitis, low facial bone density, multiple mediastinal and hilar lymphadenopathy, diffuse small pulmonary nodules, and hepatomegaly. A cutaneous lesion biopsy, the nasal mucosa, and the liver showed a chronic inflammatory granulomatosis process with necrosis. Serum anti-neutrophil cytoplasmic antibody (ANCA) against PR3 was positive. The clinical, biological, radiological, and histological findings substantiated the diagnosis of GPA. The patient received systemic steroids combined with cyclophosphamide pulses on days 1, 14 and 28 and then he was lost to follow-up. Two-years later, he presented with a cardiac failure and skin ulcer in the right lower limb. A nasal endoscopic exam showed nasal septum cartilage perforation with resorption of the middle and inferior nasal concha. Two weeks later, he developed a diffuse alveolar hemorrhage and was therefore transferred to the intensive care unit but died of respiratory failure 3 days later. Conclusion: Clinicians should be aware of GPA atypical clinical manifestations.

show abstract

“…A calibration curve and decision curve analysis (DCA) were used to evaluate the clinical applicability of the nomogram. 17 The calibration curve was plotted through bootstrap sampling 2000 times, and it showed that the predicted values by the nomogram were in line with the actually observed values (Fig. 3A).…”

Section: Establishment and Validation Of A Predictive Modelsupporting

confidence: 59%

Prognostic value of the platelet, neutrophil, monocyte, basophil, and eosinophil to lymphocyte ratios in patients with severe community-acquired pneumonia (SCAP)

Cui,

Xie,

Zhu

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Severe community-acquired pneumonia (SCAP) is a serious respiratory inflammation disease with high morbidity and mortality. This study aimed to evaluate the prognostic value of the platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), basophil-to-lymphocyte ratio (BLR) and eosinophil-to-lymphocyte ratio (ELR) in patients with SCAP. The study retrospectively included 554 patients with SCAP, and the clinical data were obtained from the electronic patient record (EMR) system. The primary outcome was in-hospital mortality, and the secondary outcomes included hospital length of stay (LOS), overall survival (OS), admission to ICU, ICU LOS, and ICU mortality. As a result, both increased NLR and BLR were significant but independent risk factors for in-hospital mortality; NLR was negatively correlated with hospital LOS while ELR was positively correlated with hospital LOS; both increased NLR and BLR were associated with reduced OS, while in-creased ELR was associated with improved OS; increased PLR, NLR, MLR, and BLR were all correlated with elevated ICU admission rates, while increased ELR was correlated with reduced ICU admission rates; ELR was positively correlated with ICU LOS; both higher NLR and BLR were associated with elevated ICU mortality. In summary, NLR and BLR were useful biomarkers for clinical outcomes in patients with SCAP.

show abstract

Long-Term Prognostic Factors in Patients With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A 15-Year Multicenter Retrospective Study

Cited by 17 publications

References 38 publications

Profile, Healthcare Resource Consumption and Related Costs in ANCA-Associated Vasculitis Patients: A Real-World Analysis in Italy

Profile, Healthcare Resource Consumption and Related Costs in ANCA-Associated Vasculitis Patients: A Real-World Analysis in Italy

Case Report: An unusual presentation of granulomatosis with polyangiitis

Prognostic value of the platelet, neutrophil, monocyte, basophil, and eosinophil to lymphocyte ratios in patients with severe community-acquired pneumonia (SCAP)

Contact Info

Product

Resources

About