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BACKGROUND: Adult immunoglobulin A vasculitis (IgAV) course is variable, and its prognostic factors are poorly understood. OBJECTIVES: To identify risk factors for IgAV recurrence/relapse in adults. METHODS: 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. RESULTS: 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). LIMITATIONS: Retrospective design. CONCLUSION: 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.
Lutz et al. (Mon,) studied this question.