Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep;17(6):1599-1608.
doi: 10.1007/s11739-022-02968-0. Epub 2022 Mar 26.

Biologics for immunoglobulin A vasculitis: targeting vasculitis or comorbid disease?

Bayram Farisogullari  1 , Muserref Kasap Cuceoglu  2 , Hakan Oral  3 , Gozde Kubra Yardimci  1 , Yelda Bilginer  2 , Seza Ozen  2 , Omer Karadag  4
Affiliations

Biologics for immunoglobulin A vasculitis: targeting vasculitis or comorbid disease?

Bayram Farisogullari et al. Intern Emerg Med. 2022 Sep.

Abstract

In this study, we aimed to evaluate the clinical features and treatments, including the use of biological disease-modifying anti-rheumatic drugs (bDMARDs) in a large cohort of pediatric and adult immunoglobulin A vasculitis (IgAV). Since data on the use of bDMARDs in IgAV are very limited, we collated the reasons for use of bDMARDs during the disease course. Patients who were enrolled in the Hacettepe University Vasculitis Research Centre (HUVAC) registry were included. In this prospective database dating from 2014, there were 436 IgAV patients classified as IgAV according to Ankara 2008 and/or American College of Rheumatology 1990 criteria. 88 adults and 330 pediatric IgAV patients were included as the main study group. Concomitant spondyloarthritis (SpA) was observed only in adult patients (10% vs 0% in children, p < 0.001). IgAV relapse was more common in adults than in children (p: 0.017). Adult patients were mostly treated with corticosteroid (p < 0.001) and conventional synthetic disease-modifying anti-rheumatic drug treatment (< 0.001), while more than half of the pediatric patients were followed up without immunosuppressive treatment. Ten (11%) adult patients used biologics. Among them, two patients used rituximab due to IgAV disease activity, three used infliximab due to SpA, three used etanercept due to SpA (one patient had a pediatric onset enthesitis-related arthritis), and two used anakinra due to recurrent familial Mediterranean fever attacks. This is the first study evaluating the use of all bDMARDs for any reason in the IgAV cohorts in the literature. None of the pediatric patients used biologics. Our data suggest biologics are mainly used for comorbid inflammatory diseases over refractory vasculitis in adult IgAV.

Keywords: Anti-TNF agents; Biologics; Henoch–Schönlein purpura; IgA vasculitis; Rituximab; bDMARDs.

PubMed Disclaimer

References

    1. Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F et al (2013) 2012 revised international Chapel Hill consensus conference nomenclature of vasculitides. Arthritis Rheum 65(1):1–11 - PubMed
    1. Brogan P, Eleftheriou D, Dillon M (2010) Small vessel vasculitis. Pediatr Nephrol 25(6):1025–1035 - PubMed
    1. Pillebout E, Thervet E, Hill G, Alberti C, Vanhille P, Nochy D (2002) Henoch-Schonlein purpura in adults: outcome and prognostic factors. J Am Soc Nephrol 13(5):1271–1278 - PubMed
    1. Batu ED, Sari A, Erden A, Sonmez HE, Armagan B, Kalyoncu U et al (2018) Comparing immunoglobulin A vasculitis (Henoch-Schonlein purpura) in children and adults: a single-centre study from Turkey. Scand J Rheumatol 47(6):481–486 - PubMed
    1. Audemard-Verger A, Terrier B, Dechartres A, Chanal J, Amoura Z, Le Gouellec N et al (2017) Characteristics and management of IgA vasculitis (Henoch-Schonlein) in adults: data from 260 patients included in a French Multicenter Retrospective Survey. Arthritis Rheumatol 69(9):1862–1870 - PubMed

LinkOut - more resources