ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 2733

From a Myth to a Menace: Increased Disease Severity and Poor Outcomes in an Urban Cohort of African-American Patients with ANCA-Associat­ed Vasculitis

Kathleen Maksimowicz-McKinnon1, Philip McCarthy2, Sandeep Soman3 and John McKinnon3, 1Rheumatology, Henry Ford Hospital, Detroit, MI, 2Michigan State University College of Osteopathic Medicine, East Lansing, MI, 3Henry Ford Hospital, Detroit, MI

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: African-Americans, ANCA, Renal disease, severity and vasculitis

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Tuesday, October 23, 2018

Title: Vasculitis – ANCA-Associated Poster II

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:

Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a systemic inflammatory disorder frequently associated with significant disability and morbidity, which may lead to end-stage renal disease (ESRD) or death. The purpose of our study was to examine disease characteristics and outcomes in an urban African-American (AA) cohort with AAV and compare them with a matched Caucasian (CA) cohort with AAV.

Methods:

A detailed electronic chart review of patients with positive anti-neutrophil cytoplasmic antibody testing was performed to identify patients with AAV using the 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Patients with isolated renal disease were included if they demonstrated biopsy evidence of necrotizing pauci-immune glomerulonephritis with P-ANCA/MPO or C-ANCA/PR-3 positivity at the time of diagnosis. African-American AAV patients were matched 1:2 to CA patients with AAV by gender and age within 5 years.

Results:

21 AA patients with AAV were identified, of which fourteen (66.7%) were female, with a mean age at diagnosis of 61 years. Microscopic polyangiitis occurred more commonly in AA patients than CA patients (38% vs. 14%), while granulomatosis with polyangiitis was more common in CA patients (76% vs. 47%). AA patients had more severe disease at the time of diagnosis, with increased need on admission for ICU care (50% vs. 23%, p=0.04), mechanical ventilation (40% vs. 10%, p=0.007), hemodialysis (52% vs. 19% p=0.007), with lower hemoglobin (mean 7.0 vs. 10.0, p=0.001), and higher serum creatinine (mean 6.1 vs. 2.7, p=0.001). Although the likelihood of receiving high dose pulse steroid therapy at diagnosis was not significantly different between groups, the mean dose of prednisone initiated at disease diagnosis in AA patients was significantly lower (143 mg vs. 455 mg, p=0.004), while the concomitant use of steroid-sparing immunosuppressive agents for induction therapy did not differ significantly between groups. There was a significant increase in the incidence of ESRD in AA patients when compared to CA patients (62% vs. 19%, p=0.001) without significant differences in the prevalence or severity of hypertension and diabetes at the time of diagnosis between groups. Death occurred in 33% of the AA patients and 21% of CA patients during follow up.

Conclusion: In an urban cohort, AA patients with AAV were more likely to present with severe disease requiring ICU care, mechanical ventilation, and hemodialysis compared to Caucasian patients with AAV. Despite similar rates and severity of diabetes and hypertension in these populations, African-American patients were significantly more likely to develop ESRD. There are many factors that could influence these outcomes, including other comorbid conditions, genetics, differences in treatment and response to immunosuppressive therapies, environmental factors, and limited access to care because of socioeconomic factors. Further study is needed to better understand factors that influence AAV severity and course in this population in order to improve long-term outcomes and survival.


Disclosure: K. Maksimowicz-McKinnon, None; P. McCarthy, None; S. Soman, None; J. McKinnon, None.

To cite this abstract in AMA style:

Maksimowicz-McKinnon K, McCarthy P, Soman S, McKinnon J. From a Myth to a Menace: Increased Disease Severity and Poor Outcomes in an Urban Cohort of African-American Patients with ANCA-Associat­ed Vasculitis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/from-a-myth-to-a-menace-increased-disease-severity-and-poor-outcomes-in-an-urban-cohort-of-african-american-patients-with-anca-associat%c2%aded-vasculitis/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/from-a-myth-to-a-menace-increased-disease-severity-and-poor-outcomes-in-an-urban-cohort-of-african-american-patients-with-anca-associat%c2%aded-vasculitis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology