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

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BVAS version 3 and BVAS/GPA: standing on the same line?
Clinical Rheumatology ( IF 2.9 ) Pub Date : 2022-07-09 , DOI: 10.1007/s10067-022-06267-z
Sung Soo Ahn ₁ , Jang Woo Ha ₂ , Yong-Beom Park _{2,

3} , Sang-Won Lee _{2,

3}

Affiliation

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.

中文翻译：

BVAS 版本 3 和 BVAS/GPA：站在同一条线上？

简介/目标

伯明翰血管炎活动评分 (BVAS) 第 3 版 (BVAS 3.0) 和 BVAS/肉芽肿性多血管炎 (BVAS/GPA) 被用作抗中性粒细胞胞质抗体相关血管炎的疾病活动指标。我们评估了这些指标与 GPA 和显微镜下多血管炎 (GPA/MPA) 患者的意义之间的关联。

方法

我们回顾性回顾了我院203例GPA/MPA患者的病历。研究了 BVAS 3.0 和 BVAS/GPA 与五因素评分 (FFS) 和实验室数据之间的相关性。全因死亡、终末期肾病和疾病复发的事件被计为不良临床结局。进行多变量 Cox 危害分析以评估指标和患者结果之间的关系。

结果

纳入 GPA 和 MPA 患者 65 例 (32.0%) 和 138 例 (68.0%)。MPA 患者的中位 BVAS 3.0 显着高于 GPA 患者（13.0 对 11.0，p = 0.015），而 GPA 患者的 BVAS/GPA 更高（4.0 对 3.0，p = 0.001）。BVAS 3.0 和 BVAS/GPA 显着相关（r = 0.670，p < 0.001）；BVAS 3.0 和 BVAS/GPA 均显示与在单独的 Cox 模型中调查的结果相关。然而，在 MPA 患者亚组中，BVAS 3.0 和 BVAS/GPA 之间的相关性尤其高于 GPA 患者（MPA：r = 0.817，p < 0.001 与 GPA：r = 0.570，p < 0.001) 和肾脏受累 ( r = 0.676, p < 0.001)。