P0367STATIN THERAPY AS A PROTECTOR FACTOR OF VENOUS THROMBOEMBOLIC EVENTS IN PATIENTS WITH ANCA-GLOMERULONEPHRITIS ?

Abstract

Abstract Background and Aims The incidence of venous thromboembolisms (VTE) is greatly increased in patients with anti-neutrophil cytoplasmic antibody (ANCA)- associated vasculitis (AAV). However, its incidence and risk factors in patients with ANCA-glomerulonephritis (ANCA-GN) has been poorly analyzed. Thus, the aim of the present study was to assess the frequency, the risk factors and outcomes of patients with VTE after ANCA-GN diagnosis. Method Patients from the Maine-Anjou AAV registry with a biopsy showing pauci-immune glomerulonephritis between 01/01/2000 and 01/01/2019, were included. VTE events, the site and delay from AAV diagnosis were retrieved from patient’s medical records. Results Among the 165 patients, 133 fulfilled the inclusion criteria and were analyzed. After exclusion of arterio-venous fistulae thrombotic events, VTE episodes were diagnosed in 23/133 (17.3%) at a median delay of 3 months from ANCA-GN diagnosis or relapse. As compared to patients that did not developed VTE, patients with VTE had less frequently PR3 ANCAs (p=0.05), tended to be older (p=0.081), had lower serum albumin at AAV diagnosis (p=0.040) and were less frequently on statin therapy (p=0.028). Univariate cox analysis identified age (HR 1.49 for each 10-year increase, p=0.028), serum albumin at diagnosis (HR 2.21 for each 10g/L decrease, p=0.045), lack of statin therapy (HR 5.26, p=0.008) and rituximab treatment (HR 4.10, p=0.026) to be significantly associated with VTE occurrence. However, after adjustment in the multivariate model, only lack of statin therapy (HR 4.80; p=0.039) was significantly associated with VTE, while serum albumin was borderline (HR 2.20 for each 10 g/L decrease, p=0.067). Patients with VTE developed more frequently end-stage renal disease (p=0.040), but AAV relapse rate and mortality were not significantly different as compared to patients without VTE. Conclusion Patients with ANCA-GN are at high risk of VTE, especially within the first months following AAV diagnosis. We identified the lack of statin therapy as an independent risk factors of VTE development in our cohort. Thus, our results suggest that statins may have anti-thrombotic properties in ANCA-GN, which opens new therapeutic perspectives.