SAT0547 Prognostic nutritional index for estimating birmingham vasculitis activity score in anca-associated vasculitis. (12th June 2018)

• Record Type: Journal Article
• Authors: Ahn, S.S.; Yoo, J.; Jung, S.M.; Song, J.J.; Park, Y.-B.; Lee, S.-W.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1127
• Page End: 1128
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.4991
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: The prognostic nutritional index (PNI), which was first introduced by Onodera et al., is calculated based on the serum albumin level and total lymphocyte count in the peripheral blood. It is proposed to be a parameter to reflect immunonutritional status, however, it is also known that albumin and lymphocyte count may decrease in proportion to inflammatory burdens in autoimmune diseases. Objectives: We investigated whether PNI at diagnosis can be used for estimating BVAS at diagnosis in antineutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) patients. Methods: We retrospectively reviewed the medical records of 160 patients with AAV. We calculated Birmingham vasculitis activity score (BVAS). We collected laboratory results including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), while blood cell, lymphocyte and platelet counts and serum albumin. Prognostic nutritional index (PNI) was calculated by (10 x serum albumin (g/dl)+0.005 x lymphocyte count (/mm3)). The association was assessed linear regression analyses. The optimal cut-off of PNI for predicting relapse was set at 36.6. Comparison of cumulative relapse free survival was analysed by the Kaplan-Meier survival analysis. Results: The mean age at diagnosis was 55.2 years and 48 patients were male. Eighty-five patients had MPA, 41 patients had GPA and 34 patients had EGPA. The mean BVAS and PNI at diagnosis were 11.9 and 43.4. Forty-three patients experienced relapse of AAV. In univariable linear regression analysis, BVAS was positively correlated with ESR and CRP and was negatively correlated with lymphocyte count, serum albumin level and PNI. In multivariable analysis, BVAS was the most significantly associated with only PNI (standardised β=−0.296). Patients having PNI at diagnosis ≤36.6 exhibited significantly lower cumulative relapse free survival rate than those having PNI at diagnosis >36.6 (p=0.002). Conclusions: PNI at diagnosis can be used to estimate BVAS at diagnosis and PNI at diagnosis ≤36.6 may predict relapse during the follow-up in AAV patients. References: [1] Nihon Geka Gakkai Zasshi1984;85:1001–5. [2] J Cancer Res Clin Oncol Oncol2014;140:1537–49. [3] Arthritis Rheum2013;65:1–11. Acknowledgements: None. Disclosure of Interest: None declared