{"doi":"10.1002/acr.25329","title":"<scp>Patient‐Reported</scp> Sinonasal Symptoms and Risk of Relapse in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis","abstract":"OBJECTIVE: Relapses are frequent and difficult to predict in antineutrophil cytoplasmic antibody-associated vasculitis (AAV), resulting in long-term use of immunosuppression. Although sinonasal disease is associated with relapse of AAV, detailed characterization of sinonasal symptoms is lacking. Using a patient-reported outcome, the 22-item SinoNasal Outcome Test (SNOT-22), we investigated the relationship between sinonasal symptoms and disease activity in AAV. METHODS: This was a prospective, longitudinal study of individual with AAV and healthy individuals. Relapse was defined as a Birmingham Vasculitis Activity Score for Wegner's Granulomatosis score >0. Higher SNOT-22 scores indicate worse symptoms. Generalized estimating equation and Cox proportional hazard models evaluated the association between SNOT-22 and relapse. RESULTS: There were 773 visits (106 active disease visits) from 168 patients with AAV and 51 controls. Median SNOT-22 at remission was higher in AAV versus controls (20 vs 5; P < 0.001) and higher during active disease versus remission (P < 0.001). In all AAV, and particularly within granulomatosis with polyangiitis, higher SNOT-22 scores were observed months to years before relapse and were associated with increased risk of relapse (hazard ratio 2.7, 95% confidence interval 1.2-6.2; P = 0.02). Similar findings were seen when examining patients with versus without sinonasal disease and after removing relapses limited to the ear, nose, and throat. CONCLUSION: A patient-reported outcome measure of sinonasal disease, the SNOT-22, not only changes with disease activity in AAV, but also is associated with a higher risk of relapse within two years. These findings support the possibility that the SNOT-22 score may enhance prediction of relapse and that persistent sinonasal disease may be important in the pathophysiology of relapse.","journal":"Arthritis Care & Research","year":2024,"id":448453,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9591,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":305807,"name":"Shubhasree Banerjee","orcid":"0000-0003-0903-1949","position":1,"is_corresponding":false},{"id":1267034,"name":"Naomi A. Amudala","orcid":"0000-0001-7310-3594","position":2,"is_corresponding":false},{"id":470198,"name":"Sherry Chou","orcid":"0000-0002-5483-2908","position":3,"is_corresponding":false},{"id":1267035,"name":"Ruolan Li","orcid":"0000-0002-0110-1095","position":4,"is_corresponding":false},{"id":476177,"name":"Hongzhe Lee","orcid":null,"position":5,"is_corresponding":false},{"id":264137,"name":"Noam A. Cohen","orcid":"0000-0002-9462-3932","position":6,"is_corresponding":false},{"id":5969,"name":"Peter A. Merkel","orcid":"0000-0001-9284-7345","position":7,"is_corresponding":false},{"id":251782,"name":"Rennie L. Rhee","orcid":"0000-0002-4907-0304","position":8,"is_corresponding":false},{"id":1267033,"name":"Ellen Romich","orcid":"0000-0002-8233-4703","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-19T02:02:08.018689Z","pmid":"38523260","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}