RESUMO
BACKGROUND: ANCA (antineutrophil cytoplasmatic antibody)-associated vasculitis (AAV) mainly affects elderley people but adjusted therapy concepts for this patient group are lacking. AIM: The aim of this study was therefore to analyze differences in course and outcome of patients with AAV with respect to age. MATERIALS AND METHODS: 62 patients were analyzed for treatment response, of whom 53 (85%) experienced adverse events (AE and SAE) that could be evaluated. Older (>â¯65â¯yrs.) versus younger (<â¯65â¯yrs.) patients were compared. Treatment response was assessed at 6 months, complications were assessed over 18 months. RESULTS: Treatment response was not seen to differ by age groups. In multiple logistic regression, pulmonary involvement (ORâ¯=â¯6,9; CIâ¯=â¯1,7-27,8, pâ¯<â¯0,01) and ΔGFR [ml/min] (ORâ¯=â¯0,93; CIâ¯=â¯0,89-0,97, pâ¯<â¯0,01) were predictors of SAE. 14 patients had more than 1 SAE. Again, pulmonary involvement (28,2% vs. 78,6%, pâ¯<â¯0,01) was a risk factor and older patients (78,6% vs. 43,6%, pâ¯=â¯0,025) were more frequently affected. Patients with multiple SAEs received glucocorticoids of more than 5â¯mg/d for longer periods of time (171 ± 65 days vs. 120 ± 70 days, pâ¯=â¯0,03). DISCUSSION: No differences were found between older and younger patients with regard to treatment response. Multiple SAEs occurred more frequently in elderly patients. There was a correlation between pulmonary manifestation and duration of glucocorticoid therapy with a complicated course. The most frequent SAEs were infections requiring hospitalisation. CONCLUSION: Therapy for elderly patients should be individualized with the goal of a fast reduction of glucocorticoids. Special monitoring is indicated for elderly patients, especially those with pulmonary involvement.