Novel insights into the aetiology of granulomatosis with polyangiitis—a case–control study using the Clinical Practice Research Datalink
Objectives We aimed to provide insights into the aetiology of granulomatosis with polyangiitis (GPA), by conducting a large case–control study using a general population-based, prospectively collected database of healthcare records. Methods We compared all incident cases of GPA in the Clinica...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Oxford University Press
2018
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| Online Access: | https://eprints.nottingham.ac.uk/50009/ |
| _version_ | 1848798129252466688 |
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| author | Pearce, Fiona A. Lanyon, Peter C. Watts, Richard A. Grainge, Matthew J. Abhishek, Abhishek Hubbard, Richard B. |
| author_facet | Pearce, Fiona A. Lanyon, Peter C. Watts, Richard A. Grainge, Matthew J. Abhishek, Abhishek Hubbard, Richard B. |
| author_sort | Pearce, Fiona A. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Objectives
We aimed to provide insights into the aetiology of granulomatosis with polyangiitis (GPA), by conducting a large case–control study using a general population-based, prospectively collected database of healthcare records.
Methods
We compared all incident cases of GPA in the Clinical Practice Research Datalink 1990–2014, with up to 10 age-, sex- and general practice-matched controls. We identified potential risk factors, recorded numbers of cases and controls exposed to each, and calculated odds ratios (ORs) using conditional logistic regression. Our main analysis excluded data recorded during 1 year before diagnosis, to prevent early symptoms being mistaken for risk factors.
Results
We identified 757 people with GPA and matched 7546 controls. People with GPA were five times more likely to have a previous diagnosis of bronchiectasis (OR = 5.1, 95% CI: 2.7, 9.4; P < 0.0001), and these effects remained stable in diagnoses recorded >5 years prior to diagnosis. People with GPA were two to three times more likely than controls to have previous diagnoses of autoimmune diseases or chronic renal impairment, and these effects also remained stable >5 years prior to diagnosis. People with GPA were more likely to have a diagnosis of pulmonary fibrosis (OR = 5.7, 95% CI: 1.7, 19.5; P = 0.01) and sinus infections (OR = 2.7, 95% CI: 1.8, 4.2; P < 0.0001) recorded in the 3 years before diagnosis, but not before this. We also found former smoking, some medications and higher socio-economic status significantly, but less strongly, associated.
Conclusion
We found novel long-term associations between GPA and pre-existing bronchiectasis and autoimmune diseases. |
| first_indexed | 2025-11-14T20:14:52Z |
| format | Article |
| id | nottingham-50009 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T20:14:52Z |
| publishDate | 2018 |
| publisher | Oxford University Press |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-500092018-03-07T03:32:55Z https://eprints.nottingham.ac.uk/50009/ Novel insights into the aetiology of granulomatosis with polyangiitis—a case–control study using the Clinical Practice Research Datalink Pearce, Fiona A. Lanyon, Peter C. Watts, Richard A. Grainge, Matthew J. Abhishek, Abhishek Hubbard, Richard B. Objectives We aimed to provide insights into the aetiology of granulomatosis with polyangiitis (GPA), by conducting a large case–control study using a general population-based, prospectively collected database of healthcare records. Methods We compared all incident cases of GPA in the Clinical Practice Research Datalink 1990–2014, with up to 10 age-, sex- and general practice-matched controls. We identified potential risk factors, recorded numbers of cases and controls exposed to each, and calculated odds ratios (ORs) using conditional logistic regression. Our main analysis excluded data recorded during 1 year before diagnosis, to prevent early symptoms being mistaken for risk factors. Results We identified 757 people with GPA and matched 7546 controls. People with GPA were five times more likely to have a previous diagnosis of bronchiectasis (OR = 5.1, 95% CI: 2.7, 9.4; P < 0.0001), and these effects remained stable in diagnoses recorded >5 years prior to diagnosis. People with GPA were two to three times more likely than controls to have previous diagnoses of autoimmune diseases or chronic renal impairment, and these effects also remained stable >5 years prior to diagnosis. People with GPA were more likely to have a diagnosis of pulmonary fibrosis (OR = 5.7, 95% CI: 1.7, 19.5; P = 0.01) and sinus infections (OR = 2.7, 95% CI: 1.8, 4.2; P < 0.0001) recorded in the 3 years before diagnosis, but not before this. We also found former smoking, some medications and higher socio-economic status significantly, but less strongly, associated. Conclusion We found novel long-term associations between GPA and pre-existing bronchiectasis and autoimmune diseases. Oxford University Press 2018-02-26 Article PeerReviewed application/pdf en cc_by https://eprints.nottingham.ac.uk/50009/1/kex512.pdf Pearce, Fiona A., Lanyon, Peter C., Watts, Richard A., Grainge, Matthew J., Abhishek, Abhishek and Hubbard, Richard B. (2018) Novel insights into the aetiology of granulomatosis with polyangiitis—a case–control study using the Clinical Practice Research Datalink. Rheumatology . ISSN 1462-0332 Anti-neutrophil cytoplasmic antibody-associated vasculitis; Granulomatosis with polyangiitis; Risk factors; Aetiology vasculitis https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/kex512/4910365 doi:10.1093/rheumatology/kex512 doi:10.1093/rheumatology/kex512 |
| spellingShingle | Anti-neutrophil cytoplasmic antibody-associated vasculitis; Granulomatosis with polyangiitis; Risk factors; Aetiology vasculitis Pearce, Fiona A. Lanyon, Peter C. Watts, Richard A. Grainge, Matthew J. Abhishek, Abhishek Hubbard, Richard B. Novel insights into the aetiology of granulomatosis with polyangiitis—a case–control study using the Clinical Practice Research Datalink |
| title | Novel insights into the aetiology of granulomatosis with polyangiitis—a case–control study using the Clinical Practice Research Datalink |
| title_full | Novel insights into the aetiology of granulomatosis with polyangiitis—a case–control study using the Clinical Practice Research Datalink |
| title_fullStr | Novel insights into the aetiology of granulomatosis with polyangiitis—a case–control study using the Clinical Practice Research Datalink |
| title_full_unstemmed | Novel insights into the aetiology of granulomatosis with polyangiitis—a case–control study using the Clinical Practice Research Datalink |
| title_short | Novel insights into the aetiology of granulomatosis with polyangiitis—a case–control study using the Clinical Practice Research Datalink |
| title_sort | novel insights into the aetiology of granulomatosis with polyangiitis—a case–control study using the clinical practice research datalink |
| topic | Anti-neutrophil cytoplasmic antibody-associated vasculitis; Granulomatosis with polyangiitis; Risk factors; Aetiology vasculitis |
| url | https://eprints.nottingham.ac.uk/50009/ https://eprints.nottingham.ac.uk/50009/ https://eprints.nottingham.ac.uk/50009/ |