#4732 GLUCOCORTICOID-RELATED ADVERSE EFFECTS IN THE TREATMENT OF ANCA-ASSOCIATED VASCULITIS

Abstract Background and Aims Upcoming glucocorticoid (GC)-sparing treatment strategies like avacopan could potentially diminish or replace the need of GC therapy for ANCA-associated-vasculitis (AAV) in future. Therefore, a proper assessment GC-related morbidity AAV is required to provide further justification such therapies. The aim this study was therefore assess incidence common toxicities investigate effect GC-treatment on management diabetes mellitus, arterial hypertension hypercholesterolemia. Method In single-centre-cohort-study we screened medical records patients with diagnosis admitted Robert-Bosch-hospital (RBK) Stuttgart, Germany regular basis. We assessed dosage duration immunosuppressive used treat AAV, as well therapies hypertension, mellitus For study, observed vasculitis time course during acute phase (180 days) after either initial relapse each patient. Results included 74 RBK since 2004 up current date. Most subtype GPA (n = 48 patients), followed by MPA 22) EGPA 4). Including relapses, total 127 events were observed. mean 8 years (SD 3.9, 0.9 - 18.0 years). Mean 4.2 3.6, 0.3-14.7 All received prednisolone, whereas 73% furthermore administered methylprednisolone induction therapy. Overall, 34% diagnosed before (14% pre-existing diabetes, 20% new-onset diabetes). Daily accumulated GC-dose did not differ between without diabetes. However, there significant higher dose requiring insulin-therapy comparison those oral antidiabetics (p-value 0.0214). 89% treated antihypertensive (38% pre-exisiting 51% hypertension). found that prednisolone within first 180 days event significantly documented hypertension. detected subgroup whom an escalation initiated whose stable even deescalated 0.0001). With regard hypercholesterolaemia, no statistical difference statin-therapy who not. Conclusion related are AAV. This provides additional evidence about harms promote importance alternative reduced free approaches. may be relevant detecting risk groups upcoming GC-sparing essential reduce treatment-related harm.