Background/Purpose: Anti-neutrophil cytoplasmic antibody associated vasculitis (AAV) are a group of disorders predominantly affecting older patients and frequently presenting with acute kidney injury. Despite the improvements made in treating these disorders, appropriate treatment strategies in the very elderly (above the age of 80) remain undefined, as the majority of clinical trials have excluded this age group and therefore it is still unclear whether the benefits of immunosuppression outweigh the risks.

Methods: We retrospectively examined 31 cases who presented with AAV and acute kidney injury in individuals aged >80 between 2006 to 2015 with a mean follow up of 39 months

Results: 32% were PR3 positive, 58% MPO positive and 10% negative. Mean creatinine at presentation was 367 mmol/L and 48% required acute dialysis on presentation. 68% of patients were treated with Cyclophosphamide as induction therapy while 16% received Azathioprine and steroids. Infection was documented in 33% of patients. Survival rate at one year was 76% and the incidence of end-stage kidney disease was 52%.

Conclusion:   The results of this study show that a significant percentage of the very elderly patients can benefit from immunosuppresion therapy for AAV, despite the higher risks of adverse effects from these medications. However the precise details of what to give and for how long remains unclear.

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/treatment-of-anca-associated-vasculitis-in-the-very-elderly/