AB0606 Health-related quality of life in patients with rituximab-induced remission of ANCA-associated vasculitis: registry-based cohort studies

Abstract

BackgroundSurvival rate in ANCA-associated vasculitis (AAV) has significantly improved due to anti-B cell therapy with rituximab (RTX). The main issue now appears to be the management of comorbidities and the improvement of quality of life.ObjectivesBased on a prospective analysis of the single centre registry of AAV patients (pts) treated with RTX, to study the impact of sustained remission on health-related quality of life using Short-Form 36 (SF-36).MethodsHealth-related quality of life was assessed in 70 AAV pts: 35 (50%) with granulomatosis with polyangiitis (GPA), 24 (34.3%) - microscopic polyangiitis (MPA) and 11 (15,7%) - eosinophilic granulomatosis with polyangiitis (EGPA). The mean age was 49,7 ± 15,7 years, 53% women. The median total dose of RTX was 4.3± 2,5 g. As a rule, a reduced dose of RTX 500 mg was used for repeated courses. Mean duration of RTX therapy 46.8 ± 29.4 months. Remission of AAV was defined as a Birmingham Vasculitis Activity Score = 0 regardless of prednisone treatment or dosage. All pts were in remission.ResultsIn 70 patients the average indicators of physical functioning: MPA 62.5 (47.5, 78.8), GPA 75 (55, 92.5), EGPA 60 (45, 77.5); social functioning: MPA 25 (0, 56.3), GPA 50 (25, 100), EGPA 50 (12.5, 62.5), physical health component: MPA 41.6 (31.5, 44.8), GPA 43.7 (36.7, 52.5), EGPA 38.7 (33.8, 45). There were no significant differences between men and women within the GPA, MPA, and EGPA groups. There were also no differences between different age groups. When comparing the EGPA group with GPA or MPA, no significant differences were found. At the same time, in patients with MPA, the indicators of physical functioning (p=0.015, w= 3.92) and the physical component of health (p=0.012, w 4.026) were significantly lower than in patients with GPA.ConclusionRTX maintenance allows to achieve a good quality of life in AAV pts. SF-36 summary measures were significantly higher in GPA pts compared with MPA. Further research is required to analyze the effect of AAV phenotype and complications on health-related quality of life.