AB0626 Prevalence of Frailty in an Internet-Based Cohort with a Self-Reported Diagnosis of Vasculitis – The VascStrong Study

Abstract

BackgroundFrailty is a syndrome characterized by an increased vulnerability to stressors and is associated with disability and early mortality. Frailty may be accelerated in patients with vasculitis. The prevalence of frailty in patients with vasculitis remains unexplored.ObjectivesTo describe the prevalence of self-reported frailty in patients with vasculitis.MethodsVascStrong is a longitudinal study utilizing the Vasculitis Patient-Powered Research Network (VPPRN), an internet-based prospective longitudinal cohort. Data elements collected included type of vasculitis, demographic, and use of medications. Frailty was measured by the FRAIL scale, a self-report measure which queries on 5 domains: 1. Fatigue, 2. Resistance (inability to climb 10 stairs), 3. Ambulation (inability to walk several blocks), 4. Illnesses (≥5/11 comorbidities), and 5. Loss of Weight (≥5% weight loss in the last year). Patients were classified as robust, pre-frail, and frail based on 0, 1-2, or ≥ 3 criteria, respectively.ResultsThe survey collected information from October 8, 2021-January 15, 2022. For this preliminary analysis, 228 responses were included. Clinical characteristics and study data are outlined in Table 1. Prevalence of robustness, pre-frailty, and frailty was 28.5%, 47.8%, and 23.7%, respectively. The majority of patients with each form of vasculitis were rated as frail or pre-frail. Among the individual FRAIL domains, fatigue and loss of weight were the most frequent (48.7% and 42.5%, respectively) while illnesses, was the least common (3.5%). When compared to robust patients, frail and pre-frail patients were younger, more frequently female, more likely to be obese and reported more frequent use of glucocorticoids. Patients with urticarial vasculitis and Takayasu’s arteritis were more commonly pre-frail or frail, compared to patients with other types of vasculitis.Table 1.Characteristics for overall cohort and by frailty classificationOverall N = 228Robust N = 65Pre-frail N = 109Frail N = 54Age, years, mean (SD)57.6 (15.3)62.4 (14.8)55.1 (15.6)57.1 (14.3)Sex, female163 (71.5%)40 (61.5%)84 (77.1%)39 (72.2%)Race, white204 (89.5%)60 (92.3%)98 (89.9%)46 (85.2%)Ethnicity, non-Hispanic195 (85.5%)57 (87.7%)97 (89.0%)41 (75.9%)Disease duration, years, mean (SD)8.5 (7.9)8.6 (6.8)8.4 (8.4)8.8 (8.0)Employment statusEmployed98 (43.0%)24 (36.9%)60 (55.0%)14 (26.0%)Retired66 (28.9%)29 (44.6%)24 (22.0%)13 (24.1%)Disabled (unable to work)34 (14.9%)4 (6.2%)12 (11.0%)18 (33.3%)Other/missing30 (13.2%)8 (12.3%)13 (12.0%)9 (16.7%)DiagnosisGranulomatosis with polyangiitis89 (100.0%)29 (32.6%)42 (47.2%)18 (20.2%)Eosinophilic granulomatosis with polyangiitis26 (100.0%)9 (34.6%)11 (42.3%)6 (23.1%)Microscopic polyangiitis23 (100.0%)7 (30.4%)12 (52.2%)4 (17.4%)Giant cell arteritis17 (100.0%)5 (29.4%)8 (47.1%)4 (23.5%)Urticarial vasculitis14 (100.0%)2 (14.3%)5 (35.7%)7 (50.0%)Takayasu's arteritis10 (100.0%)0 (0%)7 (70.0%)3 (30.0%)Other*49 (100.0%)8 (26.5%)16 (49.0%)8 (24.5%)Body Mass IndexaUnderweight6 (2.6%)2 (3.1%)4 (3.7%)0 (0%)Normal86 (37.7%)35 (53.8%)40 (36.7%)11 (20.4%)Overweight63 (27.6%)19 (29.2%)29 (26.6%)15 (27.8%)Obese73 (32.0%)9 (13.8%)36 (33.0%)28 (51.9%)Currently on glucocorticoids104 (45.6%)19 (29.2%)52 (47.7%)33 (61.1%)Current glucocorticoid dose, prednisone equivalent (mg/d), mean (SD)13.1 (18.0)12.6 (17.1)11.3 (18.6)16.4 (17.4)Data presented as n (%), unless specified otherwise*Other diagnosis: Behçet’s disease, primary angiitis central nervous system, cryoglobulinemic vasculitis, IgA vasculitis, polyarteritis nodosa, and other/suspected diagnosisaBased on World Health Organization Body Mass Index categoriesConclusionSelf-reported frailty or pre-frailty is prevalent in the majority of patients with multiple forms of vasculitis. Future analysis will focus on identifying factors associated with frailty in patients with vasculitis, to allow earlier identification and prevention in this population at high-risk for frailty.AcknowledgementsThe investigators want to thank all participants.Disclosure of InterestsSebastian E. Sattui Grant/research support from: receives research funding related to clinical trials by AstraZeneca (MANDARA), John Stadler: None declared, Cristina Burroughs: None declared, Kalen Larson: None declared, Peter A. Merkel Consultant of: CSL Behring, Dynacure, EMDSerono, Immagene, Jannsen, Kiniksa, Kyverna, Magenta, MiroBio, Mitsubishi, Novartis, Pfizer, Regeneron, Sparrow, Talaris, AbbVie, AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Neutrolis, Takeda., Grant/research support from: AbbVie, AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Neutrolis, Takeda., Robert Spiera Consultant of: Chemocentryx, Grant/research support from: Chemocentryx