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Patient perceptions of glucocorticoids in anti-neutrophil cytoplasmic antibody-associated vasculitis

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dc.contributor Háskóli Íslands
dc.contributor University of Iceland
dc.contributor.author Robson, Joanna C.
dc.contributor.author Dawson, Jill
dc.contributor.author Cronholm, Peter F.
dc.contributor.author Ashdown, Susan
dc.contributor.author Easley, Ebony
dc.contributor.author Kellom, Katherine S.
dc.contributor.author Gebhart, Don
dc.contributor.author Lanier, Georgia
dc.contributor.author Milman, Nataliya
dc.contributor.author Peck, Jacqueline
dc.contributor.author Luqmani, Raashid A.
dc.contributor.author Shea, Judy A.
dc.contributor.author Tómasson, Gunnar
dc.contributor.author Merkel, Peter A.
dc.date.accessioned 2018-04-24T14:13:46Z
dc.date.available 2018-04-24T14:13:46Z
dc.date.issued 2017-11-09
dc.identifier.citation Robson, J. C., Dawson, J., Cronholm, P. F., Ashdown, S., Easley, E., Kellom, K. S., . . . Merkel, P. A. (2018). Patient perceptions of glucocorticoids in anti-neutrophil cytoplasmic antibody-associated vasculitis. Rheumatology International, 38(4), 675-682. doi:10.1007/s00296-017-3855-6
dc.identifier.issn 0172-8172
dc.identifier.issn 1437-160X (eISSN)
dc.identifier.uri https://hdl.handle.net/20.500.11815/697
dc.description.abstract Granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA) are multisystem diseases of small blood vessels, collectively known as the anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV). This study explores the patient’s perspective on the use of glucocorticoids, which are still a mainstay of treatment in AAV. Patients with AAV from the UK, USA, and Canada were interviewed, using purposive sampling to include a range of disease manifestations and demographics. The project steering committee, including patient partners, designed the interview prompts and cues about AAV, its treatment, and impact on health-related quality of life. Interviews were transcribed and analysed to establish themes grounded in the data. A treatment-related code was used to focus analysis of salient themes related to glucocorticoid therapy. Fifty interviews were conducted. Individual themes related to therapy with glucocorticoids emerged from the data and were analysed. Three overarching themes emerged: (1) Glucocorticoids are effective at the time of diagnosis and during relapse, and withdrawal can potentiate a flare, (2) glucocorticoids are associated with salient emotional, physical, and social effects (depression, anxiety, irritation, weight gain and change in appearance, diabetes mellitus, effect on family and work); and (3) patient perceptions of balancing the risks and benefits of glucocorticoids. Patients identified the positive aspects of treatment with glucocorticoids; they are fast-acting and effective, but, they voiced concerns about adverse effects and the uncertainty of the dose-reduction process. These results may be informative in the development of novel glucocorticoid-sparing regimens.
dc.description.sponsorship Sponsored by University of Oxford and the Vasculitis Clinical Research Consortium, with support from the US National Institute of Arthritis and Musculoskeletal and Skin Diseases (U54 AR057319 and U01 AR51874), the National Center for Research Resources (U54 RR019497); and the Office of Rare Diseases Research. Additional support for the work of the OMERACT vasculitis working group was received by a Patient-Centered Outcomes Research Institute Pilot Project Grant, the Medical Research Fund, Oxford, and the Oxfordshire Health Services Research Committee. Dr. Robson and Professor Luqmani are supported in part by the National Institute for Health Research Musculoskeletal Biomedical Research Unit, Oxford, UK. Dr. Milman was supported by a UCB/Canadian Rheumatology Association/Arthritis Society postgraduate rheumatology fellowship award and a research fellowship from the Department of Medicine at the Ottawa Hospital.
dc.format.extent 675-682
dc.language.iso en
dc.publisher Springer Nature
dc.relation.ispartofseries Rheumatology International;38(4)
dc.rights info:eu-repo/semantics/openAccess
dc.subject ANCA-associated vasculitis
dc.subject Glucocorticoids
dc.subject Patient perspectives
dc.subject Granulomatosis with polyangiitis
dc.subject Eosinophilic granulomatosis with polyangiitis
dc.subject Microscopic polyangiitis
dc.subject Æðasjúkdómar
dc.subject Æðabólgur
dc.subject Sjúklingar
dc.subject Heilsufar
dc.subject Eigindlegar rannsóknir
dc.title Patient perceptions of glucocorticoids in anti-neutrophil cytoplasmic antibody-associated vasculitis
dc.type info:eu-repo/semantics/article
dcterms.license This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
dc.description.version Peer Reviewed
dc.identifier.journal Rheumatology International;
dc.identifier.doi 10.1007/s00296-017-3855-6
dc.contributor.department Læknadeild (HÍ)
dc.contributor.department Faculty of Medicine (UI)
dc.contributor.school Heilbrigðisvísindasvið (HÍ)
dc.contributor.school School of Health Sciences (UI)

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