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Abstract: PO1613

The Effect of Cumulative UVB Dose on ANCA-Associated Vasculitis

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Scott, Jennifer, The University of Dublin Trinity College, Dublin, Ireland
  • Havyarimana, Enock, Institute of infection, immunity and inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
  • Navarro-Gallinad, Albert, The University of Dublin Trinity College, Dublin, Ireland
  • Wyse, Jason, The University of Dublin Trinity College, Dublin, Ireland
  • van Geffen, Jos, Royal Netherlands Meteorological Institute (KNMI), De Bilt, Netherlands
  • Buettner, Antonia, The University of Dublin Trinity College, Dublin, Ireland
  • Wanigasekera, Tamara, The University of Dublin Trinity College, Dublin, Ireland
  • Aslett, Louis J. M., Department of Mathematical Science, University of Durham, Durham, United Kingdom
  • Basu, Neil, Institute of infection, immunity and inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
  • Zgaga, Lina, The University of Dublin Trinity College, Dublin, Ireland
  • Little, Mark Alan, The University of Dublin Trinity College, Dublin, Ireland

Group or Team Name

  • Trinity Health Kidney Centre, Trinity College Dublin, Ireland
Background

ANCA-associated vasculitis (AAV) has a relapsing-remitting course but the precise triggers of onset and relapse are unknown. The potential effect of ultraviolet B (UVB) radiation on disease phenotype and activity, mediated by vitamin D (vitD), has been proposed, given the marked incidence variation of AAV phenotypes and serotypes with latitude. Using a well-validated vitD proxy (cumulative-weighted UVB dose (CW-D-UVB) at wavelengths that induce vitD synthesis) we hypothesized that prolonged periods of low ambient UVB are associated with an increased risk of GPA phenotype and AAV relapse in this subgroup.

Methods

The UKIVAS (n=1994) and Irish Rare Kidney Disease (RKD) (n=439) registries were used (total n=2433). Inclusion criteria: i). definite AAV diagnosis, ii). positive proteinase-3 (PR3) or myeloperoxidase (MPO) serology and/or positive histopathology. Logistic regression was used to investigate the relationship between latitude, CW-D-UVB and AAV phenotype/serotype in the entire cohort. A multi-level model was then applied to examine their effect on AAV relapse risk in the RKD subgroup.

Results

CW-D-UVB varied across seasons and latitudes. There was no relationship between latitude/CW-D-UVB at disease onset and AAV phenotype/serotype. MPA, MPO-ANCA, older age and rituximab maintenance were protective against relapse. There was no association between CW-D-UVB and relapse risk, even when examining phenotype specific risk (table 1).

Conclusion

We found no association between cumulative UVB, a validated vitD proxy, and AAV phenotype, ANCA serotype nor AAV disease activity in a genetically homogeneous cohort. These findings cast doubt on the role of vitD in AAV disease activity.

Multi-level model investigating the association between CW-D-UVB and AAV relapse