Abdominal purpura, articular involvement, fever up risk of adult IgAV recurrence

Post-bacterial aetiology and the use of systemic corticosteroid appear protective against recurrence or relapse in adult immunoglobulin A vasculitis (IgAV), reveals a study. 

On the other hand, fever at diagnosis, abdominal purpura, and articular involvement seem to contribute to an increased risk or recurrence.

Overall, 229 patients with IgAV between January 2016 and July 2022 were included in the analysis, with time to recurrence/relapse as the primary outcome.

The investigators assessed the factors associated with recurrence/relapse with hazard ratios (HRs) and 95 percent confidence intervals (CIs) and evaluated treatment effectiveness using inverse probability of treatment weighting.

Abdominal purpura (HR, 2.03, 95 percent CI, 1.16–3.58; p=0.014), articular involvement (HR, 2.29, 95 percent CI, 1.25–4.20; p=0.0074, and fever at diagnosis (HR, 3.54, 95 percent CI, 1.19–10.5; p=0.023) all significantly correlated with a higher risk of adult IgAV recurrence/relapse.

Conversely, post-bacterial cause (HR, 0.26, 95 percent CI, 0.07–0.93; p=0.039) and systemic corticosteroids administration (HR, 0.30, 95 percent CI, 0.12–0.75; p=0.0098) were associated with a lower risk.

The risk reduction associated with corticosteroids administration (HR, 0.41, 95 percent CI, 0.18–0.93; p=0.03) persisted in the inverse probability of treatment weighting analysis, but colchicine (HR, 0.84, 95 percent CI, 0.42–1.69; p=0.63) did not.

This study was limited by its retrospective design, according to the investigators.