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09-07-2022 | Vasculitis | Original Article

BVAS version 3 and BVAS/GPA: standing on the same line?

Authors: Sung Soo Ahn, Jang Woo Ha, Yong-Beom Park, Sang-Won Lee

Published in: Clinical Rheumatology | Issue 11/2022

Abstract

Introduction/objectives

Birmingham vasculitis activity score (BVAS) version 3 (BVAS 3.0) and BVAS/granulomatosis with polyangiitis (BVAS/GPA) are used as indicators of disease activity in anti-neutrophil cytoplasmic antibody-associated vasculitis. We evaluated the association between these indices and the significance in patients with GPA and microscopic polyangiitis (GPA/MPA).

Methods

We retrospectively reviewed the records of 203 patients with GPA/MPA in our hospital. The correlation between BVAS 3.0 and BVAS/GPA with the five-factor score (FFS) and laboratory data was investigated. The episodes of all-cause mortality, end-stage renal disease, and disease relapse were counted as adverse clinical outcomes. Multivariate Cox hazard analyses were performed to assess the relationships between both indices and patient outcomes.

Results

Sixty-five (32.0%) and 138 (68.0%) patients with GPA and MPA were included. The median BVAS 3.0 was significantly higher in patients with MPA than in those with GPA (13.0 vs. 11.0, p = 0.015), whereas BVAS/GPA was higher in patients with GPA (4.0 vs. 3.0, p = 0.001). BVAS 3.0 and BVAS/GPA correlated significantly (r = 0.670, p < 0.001); both BVAS 3.0 and BVAS/GPA were shown to be associated with the outcomes investigated in separate Cox models. However, the correlation between BVAS 3.0 and BVAS/GPA was especially higher in a subgroup of patients with MPA than in those with GPA (MPA: r = 0.817, p < 0.001 vs. GPA: r = 0.570, p < 0.001) and with renal involvement (r = 0.676, p < 0.001).

Conclusions

Although both BVAS 3.0 and BVAS/GPA significantly correlated and predicted outcomes well in those with GPA/MPA, a discord was observed based on disease subtypes and organ involvement.

Key Points

• BVAS 3.0 and BVAS/GPA significantly correlated and predicted outcomes in those with GPA/MPA.

• A discordance was also observed based on disease subtypes and organ involvement.

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Title: BVAS version 3 and BVAS/GPA: standing on the same line?
Authors: Sung Soo Ahn
Jang Woo Ha
Yong-Beom Park
Sang-Won Lee
Publication date: 09-07-2022
Publisher: Springer International Publishing
Keywords: Vasculitis
Vasculitis
Granulomatosis with Polyangiitis
Granulomatosis with Polyangiitis
Published in: Clinical Rheumatology / Issue 11/2022
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-022-06267-z

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Abstract

Introduction/objectives

Methods

Results

Conclusions

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