PMID- 36243413
OWN - NLM
STAT- MEDLINE
DCOM- 20230303
LR  - 20230310
IS  - 1499-2752 (Electronic)
IS  - 0315-162X (Linking)
VI  - 50
IP  - 3
DP  - 2023 Mar
TI  - Immunosuppressive Therapies in Ear, Nose, and Throat Involvement in 
      Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: Results From a 
      Multicenter Retrospective Cohort Study.
PG  - 384-389
LID - 10.3899/jrheum.220343 [doi]
AB  - OBJECTIVE: The aim of this study was to evaluate the response of ear, nose, and 
      throat (ENT) symptoms to different immunosuppressive therapies in patients with 
      antineutrophil cytoplasmic antibody-associated vasculitis (AAV). METHODS: In this 
      cohort study, patients with AAV treated between January 2010 and April 2020 at 2 
      Dutch hospitals were included. Clinical, histological, and laboratory data were 
      collected retrospectively. ENT involvement was defined as follows: (1) >/= 1 ENT 
      symptom according to the Birmingham Vasculitis Activity Score (version 3; BVAS3), 
      and/or (2) presence of saddle nose deformity. Associations between therapy and 
      ENT activity were assessed using logistic regression analysis. RESULTS: A total 
      of 320 patients with AAV were included, of whom 209 (65.3%) had ENT involvement 
      at some point throughout the disease course. In these 209 patients, median age at 
      disease onset was 52.0 years (IQR 40.0-62.0) and 45.5% were male. Median BVAS3 
      was 12.0 (IQR 6.0-18.0) at diagnosis. Despite immunosuppressive therapy, 50% (n = 
      77) of the patients had ENT symptoms at relapse and 29.1% (n = 59) had ENT 
      activity at their last visit. No statistically significant difference in ENT 
      activity at last visit was observed between patients treated with oral or 
      intravenous cyclophosphamide (CYC, n = 137) compared to rituximab (RTX, n = 55; 
      adjusted odds ratio 0.59, 95% CI 0.33-1.06; P = 0.08). Lower age at disease onset 
      and female sex were independently associated with ENT activity at last follow-up. 
      CONCLUSION: In this cohort, CYC and RTX therapy had similar therapeutic effects 
      on ENT symptoms in AAV. Persistent ENT activity is a common feature despite 
      immunosuppressive therapy.
CI  - Copyright (c) 2023 by the Journal of Rheumatology.
FAU - Krol, Roline M
AU  - Krol RM
AD  - R.M. Krol, MD, C.M. Schaap, MD, P.M.J. Welsing, PhD, M.W. Heijstek, MD, PhD, J. 
      Spierings, MD, PhD, Department of Rheumatology and Clinical Immunology, 
      University Medical Center Utrecht, Utrecht.
FAU - Schaap, Caroline M
AU  - Schaap CM
AD  - R.M. Krol, MD, C.M. Schaap, MD, P.M.J. Welsing, PhD, M.W. Heijstek, MD, PhD, J. 
      Spierings, MD, PhD, Department of Rheumatology and Clinical Immunology, 
      University Medical Center Utrecht, Utrecht.
FAU - Welsing, Paco M J
AU  - Welsing PMJ
AD  - R.M. Krol, MD, C.M. Schaap, MD, P.M.J. Welsing, PhD, M.W. Heijstek, MD, PhD, J. 
      Spierings, MD, PhD, Department of Rheumatology and Clinical Immunology, 
      University Medical Center Utrecht, Utrecht.
FAU - Klaasen, Ruth
AU  - Klaasen R
AD  - R. Klaasen, MD, PhD, Department of Rheumatology, Meander Medical Center, 
      Amersfoort.
FAU - Remmelts, Hilde H F
AU  - Remmelts HHF
AD  - H.H.F. Remmelts, MD, PhD, E.C. Hagen, MD, PhD, Department of Nephrology, Meander 
      Medical Center, Amersfoort, the Netherlands.
FAU - Hagen, E Christiaan
AU  - Hagen EC
AD  - H.H.F. Remmelts, MD, PhD, E.C. Hagen, MD, PhD, Department of Nephrology, Meander 
      Medical Center, Amersfoort, the Netherlands.
FAU - Heijstek, Marloes W
AU  - Heijstek MW
AD  - R.M. Krol, MD, C.M. Schaap, MD, P.M.J. Welsing, PhD, M.W. Heijstek, MD, PhD, J. 
      Spierings, MD, PhD, Department of Rheumatology and Clinical Immunology, 
      University Medical Center Utrecht, Utrecht.
FAU - Spierings, Julia
AU  - Spierings J
AUID- ORCID: 0000-0002-2546-312X
AD  - R.M. Krol, MD, C.M. Schaap, MD, P.M.J. Welsing, PhD, M.W. Heijstek, MD, PhD, J. 
      Spierings, MD, PhD, Department of Rheumatology and Clinical Immunology, 
      University Medical Center Utrecht, Utrecht; J.Spierings@umcutrecht.nl.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20221015
PL  - Canada
TA  - J Rheumatol
JT  - The Journal of rheumatology
JID - 7501984
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
RN  - 4F4X42SYQ6 (Rituximab)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Humans
MH  - Male
MH  - Female
MH  - *Antibodies, Antineutrophil Cytoplasmic
MH  - Retrospective Studies
MH  - Pharynx
MH  - Cohort Studies
MH  - Treatment Outcome
MH  - *Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug therapy
MH  - Rituximab/therapeutic use
MH  - Cyclophosphamide/therapeutic use
MH  - Immunosuppression Therapy
MH  - Immunosuppressive Agents/therapeutic use
OTO - NOTNLM
OT  - ANCA-associated vasculitis
OT  - cyclophosphamide
OT  - immunosuppressive therapies
OT  - otorhinolaryngology
OT  - relapse
OT  - rituximab
EDAT- 2022/10/16 06:00
MHDA- 2023/03/04 06:00
CRDT- 2022/10/15 20:42
PHST- 2022/10/03 00:00 [accepted]
PHST- 2022/10/16 06:00 [pubmed]
PHST- 2023/03/04 06:00 [medline]
PHST- 2022/10/15 20:42 [entrez]
AID - jrheum.220343 [pii]
AID - 10.3899/jrheum.220343 [doi]
PST - ppublish
SO  - J Rheumatol. 2023 Mar;50(3):384-389. doi: 10.3899/jrheum.220343. Epub 2022 Oct 
      15.