Kidney Week

Abstract: SA-PO743

French Vasculitis Study Group Score: A Predictor of Outcome or a Tool for Guiding Remission-Induction Therapy?

Session Information

• ANCA-Associated Vasculitis, Anti-GBM Disease, and Other RPGN
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Santos, Afonso, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal

Afonso Santos, MD

• Curto, Andreia, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal

Andreia Curto, MD

• Henriques, Fábio Dias, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal

Fábio Dias Henriques, MD

• Brás, Ana Catarina, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal

Ana Catarina Brás, MD

• Campos, Pedro, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal

Pedro Campos, MD

• Santos, Joana Eugénio, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal

Joana Eugénio Santos, MD

• Carrilho, Patricia S., Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal

Patricia S. Carrilho

• Theias Manso, Rita, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal

Rita Theias Manso

• Serra, Maria Adelaide, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal

Maria Adelaide Serra, DrMed

• Domingos, Fernando, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal

Fernando Domingos, MD, PhD

Background

Patients with antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) develop end-stage kidney disease, despite progress in therapy. To choose patients for whom PLEX would be helpful, the French Vasculitis Study Group (FVSG) suggested a score combining clinical and histopathologic data (Fig. 1). The aim of our study was to evaluate this score's clinical usefulness in patients with AAV.

Methods

This is a retrospective, single-center cohort study. We enrolled adult patients with AAV (kidney biopsy, suggestive clinical features and/or ANCA positivity) between 2011 and 2023. The use of PLEX was uncontrolled.
Patients were classified according to the FVSG score and divided in two groups (score >7 the threshold above which PLEX was recommended and <7). Baseline parameters, overall survival, and renal survival were compared. We further compared the subpopulation that received PLEX with those receiving only immunosuppressive drugs, using the same threshold.

Results

The baseline data of the 33 patients are described in table 1. PLEX was performed in 16 patients (48.4%). Serum albumin and creatinine levels were significantly different between the two groups (PLEX vs. no-PLEX, p=0.008). The overall survival and renal survival of patients with score >7 was lower than the patients with score <7 (p=0.015 and p=0.012, respectively, Fig 2.).
We found no differences between groups (PLEX vs no-PLEX) for patients with a clinical score >7 (table 2 and Fig. 3).

Conclusion

The FVSG score was successfully used to predict overall and renal survival using the threshold proposed. However, in our retrospective cohort, the patients that would have a survival benefit with PLEX, had similar outcomes to those who did not receive it.
In conclusion, in our cohort, this score was predictive of clinical outcome, however it was not helpful at differentiating patients who would benefit from receiving PLEX.