PMID- 33058567
OWN - NLM
STAT- MEDLINE
DCOM- 20210427
LR  - 20210427
IS  - 2326-5205 (Electronic)
IS  - 2326-5191 (Linking)
VI  - 73
IP  - 4
DP  - 2021 Apr
TI  - Multimorbidity in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: 
      Results From a Longitudinal, Multicenter Data Linkage Study.
PG  - 651-659
LID - 10.1002/art.41557 [doi]
AB  - OBJECTIVE: Antineutrophil cytoplasmic antibody-associated vasculitis (AAV) is 
      considered a chronic, relapsing condition. To date, no studies have investigated 
      multimorbidity in AAV nationally. This study was undertaken to characterize 
      temporal trends in multimorbidity and report excess health care expenditures 
      associated with multimorbidities in a national AAV cohort from Scotland. METHODS: 
      Eligible patients with AAV were diagnosed between 1997 and 2017. Each patient was 
      matched with up to 5 general population controls. Linked morbidity and health 
      care expenditure data were retrieved from a Scottish national hospitalization 
      repository and from published national cost data. Multimorbidity was defined as 
      the development of >/=2 disorders. Prespecified morbidities, individually and 
      together, were analyzed for risks and associations over time using modified 
      Poisson regression, discrete interval analysis, and chi-square test for trend. 
      The relationship between multimorbidities and health care expenditure was 
      investigated using multivariate linear regression. RESULTS: In total, 543 
      patients with AAV (median age 58.7 years [range 48.9-68.0 years]; 53.6% male) and 
      2,672 general population controls (median age 58.7 years [range 48.9-68.0 years]; 
      53.7% male) were matched and followed up for a median of 5.1 years. AAV patients 
      were more likely to develop individual morbidities at all time points, but 
      especially <2 years after diagnosis. The highest proportional risk observed was 
      for osteoporosis (adjusted incidence rate ratio 8.0, 95% confidence interval [95% 
      CI] 4.5-14.2). After 1 year, 23.0% of AAV patients and 9.3% of controls had 
      developed multimorbidity (P < 0.0001). After 10 years, 37.0% of AAV patients and 
      17.3% of controls were reported to have multimorbidity (P < 0.0001). 
      Multimorbidity was associated with disproportionate increases in health care 
      expenditures in AAV patients. Health care expenditure was highest for AAV 
      patients with >/=3 morbidities (3.89-fold increase in costs, 95% CI 2.83-5.31; P < 
      0.001 versus no morbidities). CONCLUSION: These findings emphasize the importance 
      of holistic care in patients with AAV, and may identify a potentially critical 
      opportunity to consider early screening.
CI  - (c) 2020 The Authors. Arthritis & Rheumatology published by Wiley Periodicals LLC 
      on behalf of American College of Rheumatology.
FAU - Sarica, Shifa H
AU  - Sarica SH
AUID- ORCID: 0000-0003-2574-6426
AD  - University of Aberdeen, Aberdeen, UK.
FAU - Gallacher, Peter J
AU  - Gallacher PJ
AUID- ORCID: 0000-0002-8605-2885
AD  - University of Edinburgh British Heart Foundation Center of Research Excellence, 
      University of Edinburgh, Edinburgh, UK.
FAU - Dhaun, Neeraj
AU  - Dhaun N
AUID- ORCID: 0000-0001-9128-6603
AD  - University of Edinburgh British Heart Foundation Center of Research Excellence, 
      University of Edinburgh, Edinburgh, UK.
FAU - Sznajd, Jan
AU  - Sznajd J
AD  - Raigmore Hospital, Inverness, UK.
FAU - Harvie, John
AU  - Harvie J
AD  - Raigmore Hospital, Inverness, UK.
FAU - McLaren, John
AU  - McLaren J
AD  - Whyteman's Brae Hospital, Kirkcaldy, UK.
FAU - McGeoch, Lucy
AU  - McGeoch L
AD  - Glasgow Royal Infirmary, Glasgow, UK.
FAU - Kumar, Vinod
AU  - Kumar V
AD  - Ninewells Hospital, Dundee, UK.
FAU - Amft, Nicole
AU  - Amft N
AD  - University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
FAU - Erwig, Lars
AU  - Erwig L
AD  - GlaxoSmithKline, Stevenage, UK.
FAU - Marks, Angharad
AU  - Marks A
AD  - Abertawe Bro Morgannwg University Health Board, Swansea, UK.
FAU - Bruno, Laura
AU  - Bruno L
AD  - Hamburg University of Applied Sciences, Hamburg, Germany.
FAU - Zollner, York
AU  - Zollner Y
AD  - Hamburg University of Applied Sciences, Hamburg, Germany.
FAU - Black, Corri
AU  - Black C
AD  - University of Aberdeen, Aberdeen, UK.
FAU - Basu, Neil
AU  - Basu N
AUID- ORCID: 0000-0003-4246-3145
AD  - University of Glasgow, Glasgow, UK.
LA  - eng
GR  - MR/M501633/1/MRC_/Medical Research Council/United Kingdom
GR  - RE/18/5/34216/BHF_/British Heart Foundation/United Kingdom
GR  - MR/K007017/1/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210305
PL  - United States
TA  - Arthritis Rheumatol
JT  - Arthritis & rheumatology (Hoboken, N.J.)
JID - 101623795
SB  - IM
MH  - Aged
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*epidemiology
MH  - Cardiovascular Diseases/*epidemiology
MH  - Female
MH  - Health Expenditures
MH  - Humans
MH  - Hypothyroidism/*epidemiology
MH  - Incidence
MH  - Information Storage and Retrieval
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Multimorbidity
MH  - Osteoporosis/*epidemiology
EDAT- 2020/10/16 06:00
MHDA- 2021/04/28 06:00
CRDT- 2020/10/15 17:48
PHST- 2020/08/07 00:00 [received]
PHST- 2020/10/08 00:00 [accepted]
PHST- 2020/10/16 06:00 [pubmed]
PHST- 2021/04/28 06:00 [medline]
PHST- 2020/10/15 17:48 [entrez]
AID - 10.1002/art.41557 [doi]
PST - ppublish
SO  - Arthritis Rheumatol. 2021 Apr;73(4):651-659. doi: 10.1002/art.41557. Epub 2021 
      Mar 5.