373. Patient reported outcomes (AAV-PRO) in ANCA-associated vasculitis are independent from disease activity and damage
Creators: name: Maunz1, Annika
Publisher: name: Zenodo
Year: 2022
Subjects: Vasculitis
ANCA
Abstracts
Giant Cell Arthritis
MPA
GPA
EGPA
Takayasu
IgA vasculitis

description: <strong>Background/ Objectives: </strong>The ANCA-associated vasculitis patient-reported outcome (AAV-PRO) measure is a new disease-specific PRO developed and validated to include the patient’s perspective into the overall assessment of disease (Robson et al., 2018). As a ile measure the AAV-PRO contains six different domains: Organ-specific sympto (OSS), systemic sympto severity (SSS), treatment side effects (TSE), social and emotional impact (SEI), concerns about the future (CAF), and physical function (PF). Factors that determine the patient’s perspective in AAV are yet unclear. The objective of this study was to investigate the association of disease activity and damage, depression, health-related quality of life, treatment, relapses and different organ manifestations with the patient’s AAV-PRO domain scoring. <strong>Methods:</strong> AAV-PRO, Beck’s depression inventory (BDI), short form 36 (SF-36), Birmingham Vasculitis Activity Index (BVAS) and Vasculitis Damage Index (VDI) were prospectively acquired at baseline (t1) and after 3-6 months (t2). Additionally, patient’s data concerning age, sex, disease duration, diagnosis, ANCA-state, therapies, relapses, and organ manifestations were recorded. Data were analyzed by t-tests as well as correlation and regression analyses. <strong>Results:</strong> 156 patients with AAV participated. Median AAV-PRO domain scores were higher in patients reporting “active disease” compared to patients reporting “in remission” (p&lt;0.001). When the patient cohort was divided based on objective disease activity (BVAS ≥ 1) the results of mean differences were heterogenous. The separate results for each of the six AAV-PRO domains are depicted below (table). OSS was mainly predicted by SF36 ‘pain’ and ‘general health’ as well as the number of relapses. The strongest predictors of SSS were SF36 ‘pain’ and ‘energy/fatigue’. The two of which along with SF36 ‘emotional well-being’ (EWB) were also associated with TSE, however its strongest predictor was the BDI. Especially SEI, but also CAF were chiefly predicted by the BDI and SF36 ‘EWB’. Overall, the strongest association was seen in the domain PF, which is predominantly predicted by SF36 ‘physical functioning’ ( = 0.9). Patients with longer disease duration showed higher values in TSE, SEI and CAF. No significant relations were seen between the AAV-PRO domains and BVAS, VDI, therapies, organ manifestations as well as sex and age. In the longitudinal comparison (t1/t2) there were no decisive changes of the overall results. <strong>Conclusions: </strong>Our data shows convergent validity of all six subdomains of the AAV-PRO with the established questionnaires BDI and SF-36. The degree of predictability varies and depends on the construct of each subdomain. We confirm the formerly reported strong association to the patient’s subjective state of disease in a German AAV cohort. None of the AAV-PRO domains are markedly influenced by objective parameters of disease such as BVAS and VDI. Thus, we regard the AAV-PRO as a valuable addition to the overall assessment of AAV patients. It might complement traditional endpoints like activity and damage in future clinical trials. Further investigations of the AAV-PRO in patients with more active vasculitis should be undertaken since most of the patients in our cohort were in stable remission or had low-disease activity. <strong>Disclosures:</strong> The authors declare no conflicts of interest.