AI Article Synopsis

  • The study aimed to identify risk factors for relapse and death in patients with eosinophilic granulomatosis with polyangiitis (EGPA), particularly those negative for antineutrophil cytoplasmic antibodies.
  • Among 86 patients analyzed, nearly 35% experienced relapses, and about 9% died; certain factors like severe EGPA and cardiac issues increased death risk, while prolonged corticosteroid treatments raised relapse risk.
  • Overall, relapses are common but do not affect mortality, and while cardiac involvement is frequent, chronic asthma treatment correlates with lower death risk despite higher relapse rates.

Article Abstract

Objectives: The aim was to investigate the risk factors for relapse and death in patients with eosinophilic granulomatosis with polyangiitis (EGPA) recruited at the pneumonological centre and mainly antineutrophil cytoplasmic antibody negativity.

Methods: We retrospectively recruited 86 patients. Relapse was defined as the recurrence or appearance of new organ symptoms. The study end-point included the final examination.

Results: Relapses occurred in 34.9% of the patients, while 9.3% died. Immunosuppressive therapy (P = 0.042), prolonged low-dose corticosteroid treatments (mainly for asthma) (P = 0.006), and longer follow-up duration (P = 0.004) were associated with a higher relapse risk, while advanced EGPA severity (P = 0.0015) and activity (P = 0.044), older age of onset (P = 0.030), symptomatic cardiac involvement (P = 0.007), and postinflammatory cardiac fibrosis (P = 0.038) were associated with a higher risk of death. Sinusitis (P = 0.028) and prolonged low-dose corticosteroid treatments (P = 0.025) correlated with a better prognosis. Relapses did not have an impact on the mortality (P = 0.693).

Conclusions: Relapses in EGPA remain frequent, although they do not impact mortality. Cardiac involvement is common, but clinically symptomatic cardiomyopathy is associated with a higher risk of death. Asthma requiring chronic corticosteroid treatments is associated with a lower risk of death, although the risk of EGPA recurrence is significantly higher.

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Source
http://dx.doi.org/10.1093/mr/road001DOI Listing

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