Risk factors for recurrence or relapse after a first episode of adult IgA vasculitis: A multicenter retrospective study.

Abstract

Adult immunoglobulin A vasculitis (IgAV) course is variable, and its prognostic factors are poorly understood. To identify risk factors for IgAV recurrence/relapse in adults. We included adult patients with IgAV between January 2016 and July 2022. The primary outcome was the time to recurrence/relapse. Factors associated with recurrence/relapse were assessed with hazard ratios (HR) and 95% confidence intervals (CI). Treatment effectiveness was assessed using inverse probability of treatment weighting. A total of 229 patients were included. Abdominal purpura and articular involvement were associated with a higher risk of recurrence/relapse (HR: 2.03 [95%CI: 1.16-3.58]; P = .014; HR: 2.29 [95%CI: 1.25-4.20]; P = .0074, respectively), as well as fever at diagnosis (HR: 3.54 [95%CI: 1.19-10.5]; P = .023]). Factors associated with lower risk were post-bacterial cause (HR: 0.26 [95%CI: 0.07-0.93]; P = .039) and systemic corticosteroids administration (HR: 0.30 [95%CI: 0.12-0.75]; P = .0098). In the inverse probability of treatment weighting analysis, corticosteroids were still associated with a reduced risk of recurrence/relapse (HR: 0.41 [95%CI: 0.18-0.93]; P = .03), whereas colchicine was not (HR: 0.84 [95%CI: 0.42-1.69]; P = .63). Retrospective design. Systemic corticosteroid administration and post-bacterial etiology appear to protect against recurrence/relapse in adult IgAV. Conversely, fever at diagnosis, abdominal purpura, and articular involvement may be associated with an increased risk.