Nearly 62% of patients with ANCA-associated vasculitis report neurological involvement
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SAN DIEGO — Approximately two-thirds of patients with ANCA-associated vasculitis report having neurological involvement, according to data presented at ACR Convergence 2023.
“Most data on neurologic involvement in ANCA-associated vasculitis is reported from physician reported cohorts,” Rula Hajj-Ali, MD, of the Cleveland Clinic, told Healio. “This current study report data from Vasculitis Patient-Powered Research Network (VPPRN), an online registry which is guided by our patient partners.”
To assess the impact of neurological outcomes on health-related quality of life (HRQoL) among patients with ANCA-associated vasculitis, Hajj-Ali and colleagues conducted a retrospective analysis of 2014-2022 data from the VPPRN online registry. The researchers included 1,465 adults with eosinophilic granulomatosis with polyangiitis (EGPA), granulomatosis with polyangiitis, or microscopic polyangiitis (MPA).
The researchers examined data regarding type of vasculitis, disease manifestations, how and when the vasculitis diagnosis was made, and HRQoL measures, specifically from multiple Patient-Reported Outcome Measurement Information System (PROMIS) domains.
According to the researchers, 61.5% of the cohort reported neurological involvement.
“The prevalence of neurological involvement as reported by patients is much higher compared with physician-reported data in ANCA-associated vasculitis,” Hajj-Ali said. “Further, compared to patients without neurological involvement, patients with neurological involvement are older at the time of diagnosis, more often positive for ANCA, have more different manifestations of disease, and reported greater severity of their vasculitis.”
In addition, patients with neurological involvement were more likely to be diagnosed with GPA versus EGPA or MPA. Constitutional, musculoskeletal, skin, mucous membrane, ear/nose/throat, cardiovascular, pulmonary and thrombotic manifestations of disease were all more prevalent in those with neurological involvement, the researchers wrote.
Across domains, HRQoL was lower in those with neurological involvement compared with the non-neurological involvement group. Fatigue, depression, sleep disturbance and pain interference all were higher among patients who reported neurological complications of their vasculitis.
“Neurological involvement in AAV is common and is associated with significant reductions in HRQoL,” Hajj-Ali said.
No differences were reported for patients with or without neurological involvement in terms of renal symptoms or medication use.
“Patient-generated health data and patient-reported outcomes may improve patient health awareness and communication with clinicians,” Hajj-Ali said.
“Physicians should diligently listen to patients as there is a discrepancy between physician and patient assessment,” she added said. “Rheumatologists should be aware that neurologic involvement in AAV is common and negatively affects HRQoL. In evaluating patients with AAV, rheumatologists should be evaluating for neurological involvement and any suggestive symptoms should be further evaluated to confirm the diagnosis and treat accordingly.”
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Hajj-Ali R. Abstract 2492. Presented at: ACR Convergence 2023; Nov. 10-15, 2023; San Diego.
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