Background/Purpose: ANCA-associated vasculitides (AAVs) are characterized by severe and multisystemic manifestations that greatly affect patients’ quality of life (QoL). The purpose of the study was to assess QoL of AAVs patients on targeted therapy using patient-reported outcomes (PROs) and comparing the data obtained with clinical and biohumoral profile of patients.

Methods: A cross-sectional observational study was conducted between November 2023 and May 2024 on patients with a diagnosis of AAVs, made according to ACR/EULAR 2022 classification criteria, followed at our center and in remission (BVAS=0) for at least 6 month. All patients had been on a targeted therapy (Rituximab 500 mg/6 months or on-demand for Granulomatosis with Polyangiitis (GPA) and Microscopic Polyangiitis (MPA), Mepolizumab 300 mg/4 weeks for Eosinophilic Granulomatosis with Polyangiitis (EGPA)) for at least 6 months. The validated Italian version of Short Form Health Survey – 36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy (FACIT), (ANCA-Associated Vasculitis – Patient Reported Outcome (AAV-PRO), Asthma Control Test (ACT) and Sino-Nasal Outcome Test – 22 (SNOT-22) questionnaires (the last two only in EGPAs) was administered. Demographic, clinical, and laboratory data of patients were collected and compared with indices obtained from PROs.

Results: Forty-five AAV patients were enrolled (8 MPA,14 GPA,23 EGPA), 57.8% (26/45) male. They showed a mean age of 61±12.1 years, a mean BVAS at diagnosis of 14.04±6.29 and a mean VDI at last follow-up of 3.3±2.2. 37.8% of patients were taking prednisone (mean daily dose of 3.77±1.30 mg). The characterization of patients by organ involvement can be seen in Figure 1. The mean values of indices obtained from PROs were: FACIT equal to 39.77±9.56, HADS-Anxiety 6.63±3.57, HADS-Depression 5.6±3.77, AAV-PRO SSS (Organ Specific and Systemic Symptoms and Signs) 9.37±7.80, AAV-PRO PF (Physical Function) 3.42±3.77 and AAV-PRO SEI (Social and Emotional Impact) 14.23±11.41. The results of the SF-36 subdomains are shown in Figure 2. The mean values of ACT and SNOT-22 for EGPA patients were 22.17±3.76 and 27.22±23.99, respectively.

PROs results were not correlated with vasculitis type, age, disease duration, prednisone current dose or disease-related organ involvement. The average value of VDI correlated negatively with FACIT (-0.3, p=0.04). In patients with EGPA, the presence of nasal polyposis was correlated with lower SF-36 scores in the subdomains of physical functioning, physical and emotional role limitations and energy (p=0.042, p=0.031, p=0.030, p=0.035, respectively), and severe asthma with lower values of the subdomain of general health (p=0.018).

Conclusion: AAVs patients in remission and on targeted therapy show a good quality of life, that is not dependent on disease phenotype and prior organ involvement but is partially influenced by chronic damage. The use of Mepolizumab in EGPA promotes a good subjective control of asthma and nasal polyposis, which are confirmed to be relevant factors in affecting quality of life. Further studies may evaluate the clinical utility of PROs for the characterization of response to therapies.

« Back to ACR Convergence 2024

ACR Meeting Abstracts - https://acrabstracts.org/abstract/assessment-of-the-quality-of-life-in-a-single-center-cohort-of-patients-with-anca-associated-vasculitis-on-targeted-therapy-characterization-of-global-disease-and-organ-specific-parameters-using-pat/