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

Sung Soo Ahn1, Jang Woo Ha2, Yong-Beom Park2,3

  • 1Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.

Clinical Rheumatology
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Summary
This summary is machine-generated.

Birmingham vasculitis activity score (BVAS) 3.0 and BVAS/granulomatosis with polyangiitis (BVAS/GPA) effectively predict outcomes in anti-neutrophil cytoplasmic antibody-associated vasculitis. However, their correlation varies by disease subtype and organ involvement, indicating a need for nuanced interpretation.

Keywords:
Anti-neutrophil cytoplasmic antibodyBirmingham vasculitis activity scoreGranulomatosis with polyangiitisMicroscopic polyangiitisVasculitis

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Area of Science:

  • Rheumatology
  • Clinical Immunology
  • Internal Medicine

Background:

  • Birmingham vasculitis activity score (BVAS) version 3.0 and BVAS/granulomatosis with polyangiitis (BVAS/GPA) are established disease activity indices for anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV).
  • Understanding their comparative performance and association with clinical outcomes in granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) is crucial for patient management.

Purpose of the Study:

  • To evaluate the association and predictive significance of BVAS 3.0 and BVAS/GPA in patients diagnosed with GPA and MPA.
  • To investigate the correlation between these two indices across different disease subtypes and organ involvement.

Main Methods:

  • Retrospective review of 203 patients with GPA/MPA.
  • Analysis of the correlation between BVAS 3.0, BVAS/GPA, five-factor score (FFS), and laboratory data.
  • Multivariate Cox hazard analyses were employed to assess the relationship between the indices and adverse clinical outcomes (mortality, end-stage renal disease, relapse).

Main Results:

  • BVAS 3.0 was higher in MPA patients, while BVAS/GPA was higher in GPA patients.
  • Both BVAS 3.0 and BVAS/GPA showed significant correlation with each other (r=0.670, p<0.001) and were associated with adverse outcomes.
  • The correlation between BVAS 3.0 and BVAS/GPA was stronger in MPA and in patients with renal involvement.

Conclusions:

  • Both BVAS 3.0 and BVAS/GPA are valuable tools for predicting outcomes in GPA/MPA patients.
  • A discordance in the correlation between BVAS 3.0 and BVAS/GPA exists based on disease subtypes (GPA vs. MPA) and the presence of renal involvement.
  • These findings highlight the importance of considering disease-specific characteristics when utilizing these activity scores.