135. ATHERO-THROMBOTIC AND VENOUS EVENTS (AVTE) IN EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS (EGPA): A MULTICENTRE STUDY OF 573 ITALIAN PATIENTS

Background:Eosinophilic Granulomatosis with Polyangiitis (EGPA)belongs to the spectrum of ANCA- associated vasculitis. There isgrowing evidence that systemic inflammatory diseases are associatedwith increased risk of both atherothrombotic (coronary, cerebral orperipheral) and venous (deep vein thrombosis or pulmonary embolism)thrombotic events (AVTE) and the incidence of AVTE seems to beincreasing especially during periods of active disease. This may resultin significant morbidity and mortality. The aim of this study was toinvestigate the incidence of AVTE in EGPA patients.Methods:This is a retrospective study involving 28 Italian Centreshighly qualified in management of EGPA. All patients fulfilled the ACRcriteria for EGPA or the criteria proposed in the MIRRA trial.Demographic, clinical and specific EGPA-related data were recordedat time of diagnosis, including disease manifestations and activity(BVAS score), laboratory tests, and presence of CV risk factors and CVcomorbidities. Following EGPA diagnosis, the risk of AVTE wasestimated by fitting adjusted Cox regression models to calculateHazard Ratios (HR) and related 95% Confidence Intervals (CI).Results:573 patients with EGPA were included. Seventy of them(12.2%) had a history of AVTE before EGPA diagnosis. Over a medianfollow-up of 1677 days [IQR 663–3137], 75 patients (13%) experiencedAVTE, after a median time from EGPA diagnosis of 577 days [IQR 81–2100]. Incidence of AVTE was 22.24 [95% CI 17.73–27.89] events per1000 person-years (PY) (Figure1). Namely, 33 events were venous and42 were arterial. A significant higher risk of AVTE was found forpatients with history of previous AVTE (HR 2.06 [1.15- 3.67] p¼0.015)and for those with BVAS520 at diagnosis (HR 2.02 [1.03 – 3.96] ascompared to patients with BVAS 0-9, p¼0.041). No association wasfound between other demographic, clinical and EGPA-related featuresand occurrence of AVTE. Notably, patients treated with systemicsteroids and/or with an immunomodulating therapy at diagnosisshowed a significantly lower incidence of AVTE as compared tothose who did not receive any immunosuppressive therapy within 2months from of EGPA diagnosis.Conclusion:Patients with EGPA have a high incidence of arterial andvenous thrombosis. In particular, CV risk is increased in patients withhistory of previous AVTE and with sustained disease activity.