All-cause and cause-specific mortality risks in granulomatosis with polyangiitis
department or school: Medicine, Faculty of
department or school: Medicine, Department of
data provider: DSpace
degree campus: UBCV
creator: Tan, Ju Ann
issued: 2018-08-31T00:00:00
issued: 2017
related degree: Master of Science - MSc
degree grantor: University of British Columbia
description: Background Granulomatosis with polyangiitis (GPA) is a form of ANCA-associated vasculitis (AAV), a heterogenous group of small vessel vasculitides associated with anti-neutrophil cytoplasmic antibodies (ANCA). There is still significant disease mortality despite advances in treatment of GPA. Furthermore, longitudinal data on secular trends in GPA mortality are scarce and most are from selected populations. We aim to determine all-cause and cause-specific mortality risks in GPA patients compared to the general population, as well as to estimate the difference in mortality risks in GPA patients between 1997-2004 and 2005-2012. Methods Chapter 2 was a systematic review and meta-analysis of observational studies in GPA. An extensive literature search was performed on the EMbase and Medline databases. Data was extracted for a pooled meta-analysis of standardized mortality ratios (SMR). Heterogeneity between studies was assessed using I2. Chapter 3 was a matched cohort population-based study using an administrative health database, comparing incident GPA cases and non-GPA individuals randomly selected from the general population. Primary outcome was death during the follow up period, 1997-2012. Cohorts were subdivided to early cohort (1997-2004) and late cohort (2005-2012). Hazard ratios (HR) were estimated using Cox proportional hazard regression models. Results From the meta-analysis, we found a 2.7-fold increased risk of death in AAV patients when compared to the general population. Subgroup analyses showed that mortality risks were higher in older cohorts with a trend towards improvement over time (i.e., midpoint of enrolment periods 1980-1993 and 1994-1999, vs. 2000-2005). From the matched cohort study, 370 GPA patients and 3,700 non-GPA individuals were included, with 68 and 310 observed deaths, respectively. Overall, the age, sex and entry time-adjusted all-cause mortality HR in the GPA cohort was 3.12 (95%CI 2.35-4.14). There was excess mortality from CVD causes, …
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/62909
note: ALL-CAUSE AND CAUSE-SPECIFIC MORTALITY RISKS IN GRANULOMATOSIS WITH POLYANGIITIS by Ju Ann Tan MBBS, University of Malaya, Malaysia, 2003 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Experimental Medicine) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) August 2017 © Ju Ann Tan, 2017 ii Abstract Background Granulomatosis with polyangiitis (GPA) is a form of ANCA-associated vasculitis (AAV), a heterogenous group of small vessel vasculitides associated with anti-neutrophil cytoplasmic antibodies (ANCA). There is still significant disease mortality despite advances in treatment of GPA. Furthermore, longitudinal data on secular trends in GPA mortality are scarce and most are from selected populations. We aim to determine all-cause and cause-specific mortality risks in GPA patients compared to the general population, as well as to estimate the difference in mortality risks in GPA patients between 1997-2004 and 2005-2012. Methods Chapter 2 was a systematic review and meta-analysis of observational studies in GPA. An extensive literature search was performed on the EMbase and Medline databases. Data was extracted for a pooled meta-analysis of standardized mortality ratios (SMR). Heterogeneity between studies was assessed using I2. Chapter 3 was a matched cohort population-based study using an administrative health database, comparing incident GPA cases and non-GPA individuals randomly selected from the general population. Primary outcome was death during the follow up period, 1997-2012. Cohorts were subdivided to early cohort (1997-2004) and late cohort (2005-2012). Hazard ratios (HR) were estimated using Cox proportional hazard regression models. Results From the meta-analysis, we found a 2.7-fold increased risk of death in AAV patients when compared to the general population. Subgroup analyses showed that iii mortality risks were higher in older cohorts with a trend t…
has type: Thesis/Dissertation
date issued: 2017-11
is shown at: 10.14288/1.0355241
language: eng
degree discipline: Experimental Medicine
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
type: Text
identifier URI: http://hdl.handle.net/2429/62909