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- Title
Therapieansprechen und Komplikationen von älteren Patienten mit ANCA(antineutrophile cytoplasmatische Antikörper)-assoziierten Vaskulitiden.
- Authors
Schulte-Kemna, Lena; Kühne, David; Bettac, Lukas; Herrmann, Hannes; Ludwig, Ulla; Kächele, Martin; Schröppel, Bernd
- Abstract
Background: ANCA (antineutrophil cytoplasmatic antibody)-associated vasculitis (AAV) mainly affects elderley people but adjusted therapy concepts for this patient group are lacking. Aim: The aim of this study was therefore to analyze differences in course and outcome of patients with AAV with respect to age. Materials and methods: 62 patients were analyzed for treatment response, of whom 53 (85%) experienced adverse events (AE and SAE) that could be evaluated. Older (> 65 yrs.) versus younger (< 65 yrs.) patients were compared. Treatment response was assessed at 6 months, complications were assessed over 18 months. Results: Treatment response was not seen to differ by age groups. In multiple logistic regression, pulmonary involvement (OR = 6,9; CI = 1,7–27,8, p < 0,01) and ΔGFR [ml/min] (OR = 0,93; CI = 0,89-0,97, p < 0,01) were predictors of SAE. 14 patients had more than 1 SAE. Again, pulmonary involvement (28,2% vs. 78,6%, p < 0,01) was a risk factor and older patients (78,6% vs. 43,6%, p = 0,025) were more frequently affected. Patients with multiple SAEs received glucocorticoids of more than 5 mg/d for longer periods of time (171 ± 65 days vs. 120 ± 70 days, p = 0,03). Discussion: No differences were found between older and younger patients with regard to treatment response. Multiple SAEs occurred more frequently in elderly patients. There was a correlation between pulmonary manifestation and duration of glucocorticoid therapy with a complicated course. The most frequent SAEs were infections requiring hospitalisation. Conclusion: Therapy for elderly patients should be individualized with the goal of a fast reduction of glucocorticoids. Special monitoring is indicated for elderly patients, especially those with pulmonary involvement.
- Subjects
OLDER patients; PHYSICAL mobility; DISEASE risk factors; KIDNEY diseases; AGE groups; FRAILTY; RHEUMATOLOGY; TREATMENT duration; PULMONARY manifestations of general diseases; LOGISTIC regression analysis
- Publication
Zeitschrift für Gerontologie und Geriatrie, 2023, Vol 56, Issue 8, p661
- ISSN
0948-6704
- Publication type
Article
- DOI
10.1007/s00391-022-02145-0