Older age at vasculitis diagnosis linked with higher risk for systemic damage
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PHILADELPHIA — Patients who are diagnosed with ANCA-associated vasculitis at an older age are more likely to accrue higher levels of systemic damage than patients diagnosed at a younger age, according to data presented at ACR Convergence 2022.
“We know that kids have different risk factors, whether it is due to growth and puberty or psychosocial risk factors, or even metabolize medications differently from older age groups,” Jessica Bloom, MD, MSc, an attending pediatric rheumatologist from the Children’s Hospital of Colorado, said during a press conference. “We really wanted to focus this study on looking at ANCA-associated vasculitis in kids vs. other age groups across the life span.”
To investigate the differences between juvenile and adult patients who have been diagnosed with ANCA-associated vasculitis (AAV), Bloom and colleagues conducted a retrospective cohort analysis. The analysis consisted of patients with granulomatosis with polyangiitis and microscopic polyangiitis who were enrolled in the Vasculitis Clinical Research Consortium Longitudinal Studies from 2013 through 2021. Patients were categorized based on age at the time of diagnosis. The categories included children aged younger than 18 years, young adults aged 18 to 40 years, middle-aged adults aged 40 to 65 years and older adults aged older than 65 years. Outcomes of interest included demographics, ANCA types and clinical characteristics of disease.
In all, the analysis included 1,020 patients, consisting of 61 children, 240 young adults, 560 patients who were middle-aged and 159 older adults. Additionally, 893 (92%) patients who had available ANCA results were ANCA-positive. In patients who were diagnosed with AAV at a younger age, a higher percentage of patients were female, but that disparity disappeared in older age groups. In addition, the vasculitis damage scores and ANCA Vasculitis Index of Damage scores were higher in patients aged older than 65 years compared with those diagnosed as children (1.73 and 2.52, respectively; 95% CI, 1.03-2.43).
“Looking at why this is so important, I think this study shows, one, that we could use an adult registry in order to further characterize rare diseases in children, where we don’t really have databases or enough patients in our own facilities to study these diseases,” Bloom said during the press conference. “We may really need to think about different needs in each age group and how that may impact our medication practices.”
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Bloom J. Abstract #0513. Presented at: ACR Convergence 2022; Nov. 10-15, 2022 (hybrid meeting).
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