TY - JOUR T1 - Effect of Treatment on Damage and Hospitalization in Elderly Patients with Microscopic Polyangiitis and Granulomatosis with Polyangiitis JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.190019 SP - jrheum.190019 AU - Maria Weiner AU - Su Mein Goh AU - Aladdin J. Mohammad AU - Zdenka Hrušková AU - Anisha Tanna AU - Phoebe Sharp AU - Amy Kang AU - Annette Bruchfeld AU - Daina Selga AU - Zdeňka Chocová AU - Kerstin Westman AU - Per Eriksson AU - Lorraine Harper AU - Charles D. Pusey AU - Vladimír Tesař AU - Alan D. Salama AU - Mårten Segelmark Y1 - 2019/07/15 UR - http://www.jrheum.org/content/early/2019/12/09/jrheum.190019.abstract N2 - Objective Age is a risk factor for organ damage, adverse events, and mortality in microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA). However, the relationship between treatment and damage, hospitalizations, and causes of death in elderly patients is largely unknown. Methods Consecutive patients from Sweden, the United Kingdom, and the Czech Republic diagnosed between 1997 and 2013 were included. Inclusion criteria were a diagnosis of MPA or GPA and age 75 years or more at diagnosis. Treatment with cyclophosphamide (CYC), rituximab (RTX), and corticosteroids the first 3 months was registered. Outcomes up to 2 years from diagnosis included Vasculitis Damage Index (VDI), hospitalization, and cause of death. Results Treatment data were available for 167 of 202 patients. At 2 years, 4% had no items of damage. There was a positive association between VDI score at 2 years and Birmingham Vasculitis Activity Score at onset, and a negative association with treatment using CYC or RTX. Intravenous methylprednisolone dose was associated with treatment-related damage. During the first year, 69% of patients were readmitted to hospital. Myeloperoxidase–antineutrophil cytoplasmic antibody positivity and lower creatinine levels decreased the odds of readmission. The most common cause of death was infection, and this was associated with cumulative oral prednisolone dose. Conclusion Immunosuppressive treatment with CYC or RTX in elderly patients with MPA and GPA was associated with development of less permanent organ damage and was not associated with hospitalization. However, higher doses of corticosteroids during the first 3 months was associated with treatment-related damage and fatal infections. ER -