Long-Term Outcome and Prognostic Factors of Complications in Thromboangiitis Obliterans (Buerger’s disease): A Multicenter Study of 224 Patients

Alexandre LE JONCOUR¹, Simon Soudet², Axelle Dupont³, Olivier Espitia⁴, Fabien Koskas⁵, Philippe Cluzel⁶, Pierre-Yves Hatron², Joseph Emmerich⁷, Patrice Cacoub¹, Matthieu Resche-Rigon³, Marc Lambert² and David Saadoun¹, ¹Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), F-75005, Paris, France; INSERM, UMR_S 959, F-75013, Paris, France; CNRS, FRE3632, F-75005, Paris, France; AP-HP, Groupe Hospitalier Pitié, Paris, France, ²Département de Médecine Interne et Immunologie Clinique, CHU Lille, F-59000 Lille, France, Centre National de Référence des Maladies Autoimmunes et Systémiques Rares (Sclérodermie), France, Lille, France, ³3Service de Biostatistique et Information médicale, Hôpital Saint-Louis, APHP, Paris, France, Paris, France, ⁴Département de Médecine interne, CHU de Nantes, France, Nantes, France, ⁵Service de chirurgie vasculaire, Groupe Hospitalier Pitié-Salpétrière, Paris, France, Paris, France, ⁶Service d’Imagerie Cardiovasculaire, Institut de cardiologie, Groupe Hospitalier Pitié-Salpétrière, Paris, France, Paris, France, ⁷Department of Vascular Medicine and Cardiology, University Hospital Hotel Dieu, University Paris-Descartes, Paris, France, Paris, France

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: prognostic factors, tobacco use and vasculitis

Session Information

Date: Monday, October 22, 2018

Session Title: 4M091 ACR Abstract: Vasculitis–Non-ANCA-Assocd & Rel D/Os I: Population-Based Studies(1881–1886)

Session Type: ACR Concurrent Abstract Session

Session Time: 2:30PM-4:00PM

Background/Purpose: Data regarding long term outcome of patients with thromboangiitis obliterans (TAO) are lacking and most series come from India and Japan. We assess long-term outcome and prognostic factors in a large cohort of TAO.

Methods: Retrospective multicenter study of characteristics and outcomes of 224 TAO patients fulfilling Papa’s and/or 5 Shinoya’s criterias were analyzed. Factors associated with vascular events and amputations were identified.

Results: The median age at diagnosis was 38.5 [32-46] years, 51 (23.8 %) patients were female and 81.7% were Caucasians. After a mean follow up of 5.7 years, vascular events were observed in 58.9%, amputations in 21.4% and death in 1.4%. The 5-, 10- and 15-year vascular event free survival and amputation free survival were 41% and 85%, 23% and 74% and 19% and 66%, respectively. Ethnic group (non-Caucasian) (HR 2.35 [1.30-4.27] p=0.005) and limb infection at diagnosis (3.29 [1.02-10.6] p=0.045) were independent factors of vascular events. Factor associated with amputation was limb infection (HR=12.1[3.5-42.1], p<0.001). Patient who stopped their tobacco consumption had lower risk of amputation (p=0.001) than those who continued.

Conclusion: This nationwide study shows that 34% of TAO patients will experience an amputation within 15 years from diagnosis. We identified specific characteristics that identified those at highest risk for subsequent vascular complications and amputations.

Disclosure: A. LE JONCOUR, None; S. Soudet, None; A. Dupont, None; O. Espitia, None; F. Koskas, None; P. Cluzel, None; P. Y. Hatron, None; J. Emmerich, None; P. Cacoub, None; M. Resche-Rigon, None; M. Lambert, None; D. Saadoun, None.

To cite this abstract in AMA style:

LE JONCOUR A, Soudet S, Dupont A, Espitia O, Koskas F, Cluzel P, Hatron PY, Emmerich J, Cacoub P, Resche-Rigon M, Lambert M, Saadoun D. Long-Term Outcome and Prognostic Factors of Complications in Thromboangiitis Obliterans (Buerger’s disease): A Multicenter Study of 224 Patients [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/long-term-outcome-and-prognostic-factors-of-complications-in-thromboangiitis-obliterans-buergers-disease-a-multicenter-study-of-224-patients/. Accessed June 26, 2019.

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