Bibliographic Details
| Title: |
Risk factors for serious infections and infection-related mortality in patients with microscopic polyangiitis: Multicentre REVEAL cohort study. |
| Authors: |
Manabe, Atsushi, Kadoba, Keiichiro, Hiwa, Ryosuke, Kotani, Takuya, Shoji, Mikihito, Shirakashi, Mirei, Tsuji, Hideaki, Kitagori, Koji, Akizuki, Shuji, Nakashima, Ran, Yoshifuji, Hajime, Yamamoto, Wataru, Okazaki, Ayana, Matsuda, Shogo, Gon, Takaho, Watanabe, Ryu, Hashimoto, Motomu, Morinobu, Akio |
| Source: |
Modern Rheumatology; Nov2024, Vol. 34 Issue 6, p1185-1193, 9p |
| Subject Terms: |
MICROSCOPIC polyangiitis, ANTINEUTROPHIL cytoplasmic antibodies, C-reactive protein, MEDICAL registries, COHORT analysis |
| Abstract: |
Objective: Infections are a critical concern for patients with microscopic polyangiitis (MPA). This study aimed to identify the risk factors associated with serious infections (SIs) and infection-related mortality in patients with MPA, as well as the effect of glucocorticoid (GC) dose tapering on these outcomes. Methods: This multicentre, retrospective, and observational study utilised data from a cohort of patients with MPA in Japan [Registry of Vasculitis Patients to Establish REAL World Evidence (REVEAL) cohort]. Patients were categorised based on the occurrence of SIs or infection-related deaths, and various characteristics were compared among the groups. Results: Among 182 patients, 66 (36.2%) experienced 129 SIs and 27 (14.8%) developed infection-related deaths. Advanced age, elevated C-reactive protein (CRP) levels, and higher ratio of the GC dose at 3 months to the initial dose were identified as independent risk factors for SIs. Older age was also associated with infection-related deaths. Furthermore, the cumulative incidence of infection-related deaths was significantly higher in patients with a higher ratio of the GC dose at 24 months to the initial dose. Conclusion: Older age, elevated CRP levels, and slower GC dose tapering predispose patients to SIs and infection-related deaths. Strategies, such as rapid GC dose tapering, are anticipated to mitigate the risk of infections. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
