Characteristics and Management of IgA Vasculitis (Henoch-Schonlein) in Adults Data From 260 Patients Included in a French Multicenter Retrospective Survey

Alexandra Audemard-Verger 1 Benjamin Terrier 2 Agnès Dechartres 3 Johan Chanal 4 Zahir Amoura 5 Noémie Le Gouellec 6 Patrice Cacoub 7 Noémie Jourde-Chiche 8 Geoffrey Urbanski 9 François Augusto 9 Guillaume Moulis 10 Loïc Raffray 11 Alban Deroux 12 Aurélie Hummel 13 Bertrand Lioger 14 Melanie Catroux 15 Stanislas Faguer 16 Julie Goutte 17 Nihal Martis 18 François Maurier 19 Etienne Rivière 20 Sébastien Sanges 21 Aurélie Baldolli 22 Nathalie Costedoat-Chalumeau 2 Mélanie Roriz 23 Xavier Puéchal 4 Marc André 24 Christian Lavigne 9 Boris Bienvenu 25 Arsene Mekinian 26 Elie Zagdoun Charlotte Girard 27 Alice Bérezné 1 Loïc Guillevin 28 Eric Thervet 29 Evangeline Pillebout 30
Abstract : Methods: Data on clinical characteristics, histologic features, and treatment response from 260 patients with IgAV included in a French multicenter retrospective survey were analyzed. Efficacy data were compared using different statistical models. Results: The mean ± SD age of the patients with IgAV at diagnosis was 50.1 ± 18 years, and 63% of patients were male. Baseline manifestations included purpura (100%), arthralgias/arthritis/myalgia (61%), glomerulonephritis (70%), and/or gastrointestinal involvement (53%). Thirty percent of patients showed renal failure at baseline. In univariate analysis, the response to therapy was 80% (64 of 80) in patients treated with corticosteroids (CS) alone, compared to 77% (23 of 30) in patients treated with CS plus cyclophosphamide (CYC) and 59% (10 of 17) in patients treated with colchicine (P = 0.17). Multivariable analysis showed that treatment with CS or CS plus CYC was more effective than colchicine in achieving a response. Efficacy differences were demonstrated using different statistical models: in the multivariable logistic regression model, odds ratio (OR) 3.68, 95% confidence interval (95% CI) 1.10–12.33 (P = 0.03); in the inverse probability weighting on propensity score model, OR 3.75, 95% CI 1.28–10.99 (P = 0.02). The efficacy of CS plus CYC as compared to CS alone was discordant according to the analytic method used. Analysis with the multivariable logistic regression model did not demonstrate a difference between CS plus CYC and CS alone (OR 0.88, 95% CI 0.29–2.67; P = 0.82). In contrast, inverse probability weighting on propensity score showed that CS plus CYC was more effective than CS alone (OR 1.79, 95% CI 1.00–3.20; P = 0.049). Conclusion: This series constitutes the largest series of adults with IgAV reported in the literature so far. It provides data on clinical and histologic presentation and therapeutic efficacy, suggesting that CS alone appears to be a reasonable first‐line therapy in patients with IgAV, while the benefit of adding CYC to CS remains uncertain.
Type de document :
Article dans une revue
Arthritis & rheumatology, Wiley, 2017, 69 (9), pp.1862-1870. 〈10.1002/art.40178〉
Liste complète des métadonnées

Littérature citée [36 références]  Voir  Masquer  Télécharger

https://hal-amu.archives-ouvertes.fr/hal-01787239
Contributeur : Françoise Dignat-George <>
Soumis le : lundi 14 mai 2018 - 11:49:56
Dernière modification le : mercredi 16 mai 2018 - 14:27:50

Fichier

Audemard et al, IgA VAS, A&R 2...
Fichiers produits par l'(les) auteur(s)

Identifiants

Collections

Citation

Alexandra Audemard-Verger, Benjamin Terrier, Agnès Dechartres, Johan Chanal, Zahir Amoura, et al.. Characteristics and Management of IgA Vasculitis (Henoch-Schonlein) in Adults Data From 260 Patients Included in a French Multicenter Retrospective Survey. Arthritis & rheumatology, Wiley, 2017, 69 (9), pp.1862-1870. 〈10.1002/art.40178〉. 〈hal-01787239〉

Partager

Métriques

Consultations de la notice

58

Téléchargements de fichiers

2