Five factor score of more than 1 is associated with relapse during the first 2 year-follow up in patients with eosinophilic granulomatosis with polyangiitis

Aim: We investigated what variables at diagnosis might be associated with the relapse of eosinophilic granulomatosis with polyangiitis (EGPA) and whether five factor score (FFS) at diagnosis might predict it. Methods: We reviewed the medical records of 30 patients with EGPA having results of myeloperoxidase (MPO)-antineutrophil cytoplasmic antibodies (ANCA) and proteinase 3 (PR3)-ANCA and having achieved remission during the first therapeutic regimen administration within follow-up duration for at least more than 2 years. Clinical manifestations, the presence of relapse and items for FFS at diagnosis were collected and compared among groups. Results: The mean age of patients (18 women) was 50.3 years and the mean follow-up duration was 2175 days. EGPA patients having MPO-ANCA had shown higher frequency of skin involvement and proteinuria over 1 g/day than those having PR3-ANCA and no ANCA. EGPA patients with relapse had more frequent baseline MPO-ANCA and kidney involvement,including proteinuria over 1 g/day and renal insufficiency and higher FFS at diagnosis than those without. However, only FFS showed the predictive significance for relapse (Exp(B) 2.624, P = 0.014) on Cox Hazard model analysis. When the cutoff of FFS for the relapse was set as 1, relapse was identified more frequently in patients with FFS ≥ 1 than those with FFS <1 (68.8% vs. 7.1%, P = 0.001; relative risk 28.6). Conclusion: In this study, FFS at diagnosis was associated with relapse and FFS ≥ 1 was the independent predictor of relapse during follow-up for more than 2 years.