Do Adult Disease Severity Subclassifications Predict Use of Cyclophosphamide in Children with ANCA-associated Vasculitis? An Analysis of ARChiVe Study Treatment Decisions

被引：4

作者：

Morishita, Kimberly

Guzman, Jaime

Chira, Peter ^{[2
]}

Muscal, Eyal ^{[3
]}

Zeft, Andrew ^{[4
]}

Klein-Gitelman, Marisa ^{[5
]}

Uribe, America G.

Abramson, Leslie ^{[6
]}

Benseler, Susanne M. ^{[7
]}

Eberhard, Anne ^{[8
]}

Ede, Kaleo ^{[9
]}

Hashkes, Philip J. ^{[10
]}

Hersh, Aimee O. ^{[11
]}

Higgins, Gloria ^{[12
]}

Imundo, Lisa F. ^{[13
]}

Jung, Lawrence ^{[14
]}

Kim, Susan ^{[15
]}

Kingsbury, Daniel J. ^{[16
]}

Lawson, Erica F. ^{[17
]}

Lee, Tzielan ^{[18
]}

Li, Suzanne C. ^{[19
]}

Lovell, Daniel J. ^{[20
]}

Mason, Thomas ^{[21
]}

McCurdy, Deborah ^{[22
]}

O'Neil, Kathleen M. ^{[23
]}

Punaro, Marilynn ^{[24
]}

Ramsey, Suzanne E. ^{[25
,26
]}

Reiff, Andreas ^{[27
]}

Rosenkranz, Margalit ^{[28
]}

Schikler, Kenneth N. ^{[29
]}

Scuccimarri, Rosie ^{[30
]}

Singer, Nora G. ^{[31
]}

Stevens, Anne M. ^{[32
]}

van Mater, Heather ^{[33
]}

Wahezi, Dawn M. ^{[34
]}

White, Andrew J. ^{[35
]}

Cabral, David A. ^{[1
]}

机构：

[1] British Columbia Childrens Hosp, Div Rheumatol, Vancouver, BC V6H 3V4, Canada

[2] Riley Childrens Hosp, Indianapolis, IN USA

[3] Texas Childrens Hosp, Baylor Coll Med, Houston, TX 77030 USA

[4] Cleveland Clin Fdn, Cleveland, OH 44195 USA

[5] Childrens Mem Hosp, Chicago, IL 60614 USA

[6] Univ Vermont, Burlington, VT USA

[7] Hosp Sick Children, Toronto, ON M5G 1X8, Canada

[8] Alexandra & Steven Cohen Childrens Med Ctr, New York, NY USA

[9] Phoenix Childrens Hosp, Phoenix, AZ USA

[10] Shaare Zedek Med Ctr, Jerusalem, Israel

[11] Univ Utah, Primary Childrens Med Ctr, Salt Lake City, UT USA

[12] Nationwide Childrens Hosp, Columbus, OH USA

[13] Columbia Univ, Med Ctr, New York, NY USA

[14] Childrens Natl Med Ctr, Washington, DC 20010 USA

[15] Childrens Hosp Boston, Boston, MA USA

[16] Legacy Emanuel Childrens Hosp, Portland, OR USA

[17] Univ Calif San Francisco, San Francisco, CA 94143 USA

[18] Stanford Univ, Lucile Packard Childrens Hosp, Sch Med, Stanford, CA 94305 USA

[19] Hackensack Univ, Med Ctr, Joseph M Sanzari Childrens Hosp, Hackensack, NJ USA

[20] Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH USA

[21] Mayo Clin, Mayo Eugenio Litta Childrens Hosp, Rochester, MN USA

[22] Univ Calif Los Angeles, Los Angeles, CA USA

[23] Univ Oklahoma, Hlth Sci Ctr, Oklahoma City, OK USA

[24] Univ Texas SW, Texas Scottish Rite Hosp, Dallas, TX USA

[25] IWK Hlth Ctr, Halifax, NS, Canada

[26] Dalhousie Univ, Halifax, NS, Canada

[27] Childrens Hosp LA, Los Angeles, CA USA

[28] Childrens Hosp Pittsburgh, Pittsburgh, PA 15213 USA

[29] Univ Louisville, Hlth Sci Ctr, Louisville, KY 40292 USA

[30] McGill Univ, Montreal Childrens Hosp, Ctr Hlth, Montreal, PQ H3H 1P3, Canada

[31] Rainbow Babies & Childrens Hosp, Case Med Ctr, Cleveland, OH 44106 USA

[32] Seattle Childrens Hosp, Seattle, WA USA

[33] Duke Univ, Med Ctr, Duke Childrens Hosp & Hlth Ctr, Durham, NC USA

[34] Childrens Hosp Montefiore, New York, NY USA

[35] Washington Univ, St Louis Childrens Hosp, Sch Med, St Louis, MO 63110 USA

来源：

JOURNAL OF RHEUMATOLOGY | 2012年 / 39卷 / 10期

关键词：

PEDIATRIC VASCULITIS; ANTINEUTROPRIL CYTOPLASMIC ANTIBODIES; SEVERITY; CYCLOPHOSPHAMIDE; SYSTEMIC-LUPUS-ERYTHEMATOSUS; WEGENERS-GRANULOMATOSIS; POLYANGIITIS WEGENERS; ACTIVITY SCORE; METHOTREXATE; CHILDHOOD; ONSET; GLUCOCORTICOIDS; CLASSIFICATION; PREDNISONE;

D O I：

10.3899/jrheum.120299

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective. To determine whether adult disease severity subclassification systems for antineutrophil cytoplasmic antibody-associated vasculitis (AAV) are concordant with the decision to treat pediatric patients with cyclophosphamide (CYC). Methods. We applied the European Vasculitis Study (EUVAS) and Wegener's Granulomatosis Etanercept Trial (WGET) disease severity subclassification systems to pediatric patients with AAV in A Registry for Childhood Vasculitis (ARChiVe). Modifications were made to the EUVAS and WGET systems to enable their application to this cohort of children. Treatment was categorized into 2 groups, "cyclophosphamide" and "no cyclophosphamide." Pearson's chi-square and Kendall's rank correlation coefficient statistical analyses were used to determine the relationship between disease severity subgroup and treatment at the time of diagnosis. Results. In total, 125 children with AAV were studied. Severity subgroup was associated with treatment group in both the EUVAS (chi-square 45.14, p < 0.001, Kendall's tau-b 0.601, p < 0.001) and WGET (chi-square 59.33, p < 0.001, Kendall's tau-b 0.689, p < 0.001) systems; however, 7 children classified by both systems as having less severe disease received CYC, and 6 children classified as having severe disease by both systems did not receive CYC. Conclusion. In this pediatric AAV cohort, the EUVAS and WGET adult severity subclassification systems had strong correlation with physician choice of treatment. However, a proportion of patients received treatment that was not concordant with their assigned severity subclass. (First Release Aug 1 2012; J Rheumatol 2012;39:2012-20; doi:10.3899/jrheum.120299

引用

页码：2012 / 2020

页数：9

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