Evidence map›Paper›PMID 41366827›Full record

Observational studyJournal of internal medicine2026

Overlapping forms of granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis: Insights from a European multicenter study.

Federica Pallotti, Camille Mettler, Matthias Papo, Michele Iudici, Roberto Padoan, Boris Sorin, Francesca Regola, Franco Franceschini, Sergey Moiseev, Pavel Novikov and 36 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

46 authors.

Federica PallottiDepartment of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France.ORCID https://orcid.org/0009-0009-7986-9190
Camille MettlerDepartment of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France.
Matthias PapoDepartment of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France.ORCID https://orcid.org/0000-0003-3389-9473
Michele IudiciDepartment of Internal Medicine, Division of Rheumatology, Geneva University Hospitals, Geneva, Switzerland.
Roberto PadoanDepartment of Medicine DIMED, Rheumatology Unit, University of Padua, Padua, Italy.
Boris SorinDepartment of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France.
Francesca RegolaRheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, ASST Spedali Civili and University of Brescia, Brescia, Italy.
Franco FranceschiniRheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, ASST Spedali Civili and University of Brescia, Brescia, Italy.
Sergey MoiseevTareev Clinic of Internal Disease, Sechenov First Moscow State Medical University, Moscow, Russia.ORCID https://orcid.org/0000-0002-7232-4640
Pavel NovikovTareev Clinic of Internal Disease, Sechenov First Moscow State Medical University, Moscow, Russia.
Mario Andrea PigaClinica Medica, Department of Internal Medicine, Marche University Hospital, Ancona, Italy.
Gianluca MoronciniClinica Medica, Department of Internal Medicine, Marche University Hospital, Ancona, Italy.
Silke R BrixManchester University NHS Foundation Trust, Manchester, UK.
Abdul Hadi KafagiManchester University NHS Foundation Trust, Manchester, UK.ORCID https://orcid.org/0000-0003-1214-3204
Samuel DeshayesDepartment of Internal Medicine & Clinical Immunology, Caen-Normandy University Hospital, Caen, France.
Achille AoubaDepartment of Internal Medicine & Clinical Immunology, Caen-Normandy University Hospital, Caen, France.
Julien CampagneDepartment of Internal Medicine, Robert Schuman Hospital, Metz, France.
Paolo DelvinoSchool of Medicine, University of Milano-Bicocca, Milan, Italy.
Jan Willem Cohen TervaertDepartment of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Luisa BrussinoDepartment of Medical Sciences, University of Torino & Mauriziano Hospital, Torino, Italy.
Martin MichaudDepartment of Internal Medicine, Clinique Saint-Exupery, Toulouse, France.
Nils VenhoffDepartment of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg, Germany.
Federico AlbericiNephrology Unit, University of Brescia, ASST Spedali Civili, Brescia, Italy.ORCID https://orcid.org/0000-0002-1686-5709
Claudia IannoneDepartment of Rheumatology and Medical Sciences, ASST Gaetano Pini-CTO, Milan, and Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.ORCID https://orcid.org/0009-0005-5686-0127
Sophie RosenstinglDepartment of Internal Medicine, Compiègne Noyon Hospital, Compiègne, France.
Marin MoutelDepartment of Internal Medicine, Infectious Diseases, and Clinical Immunology, Reims University Hospital, Reims, France.
Jean-Marc GalempoixDepartment of Internal Medicine, Charleville-Mézières Hospital, Charleville-Mézières, France.
Vincent CottinNational Coordinating Reference Centre for Rare Lung Diseases, Department of Pneumology, Louis-Pradel Hospital, Hospices Civils de Lyon, France.
Clara JaccardDepartment of Internal Medicine, Gaston-Bourret Territorial Hospital, Nouméa, New Caledonia.
Diane RiehlDepartment of Internal Medicine, La Seyne sur Mer Hospital, La Seyne sur Mer, France.
Paul LegendreDepartment of Internal Medicine, Centre Hospitalier Le Mans, Le Mans, France.
Anne Claire BilletDepartment of Internal Medicine, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.ORCID https://orcid.org/0000-0003-3677-0739
Paola ParronchiDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Luca QuartuccioRheumatology Division, Department of Medicine (DMED), University of Udine, Udine, Italy.
Vitor TeixeiraDepartment of Rheumatology, Universidade Local de Saúde do Algarve, Faro, Portugal.
Allyson EganTrinity Health Kidney Centre, Tallaght University Hospital, Dublin, Ireland.
David JayneDepartment of Medicine, University of Cambridge, Cambridge, UK.
Enrico TombettiDepartment of Internal Medicine, ASST Fatebenefratelli-Sacco, Fatebenefratelli Hospital, Milan, Italy.
Marco CaminatiAllergy Unit and Asthma Center, Department of Medicine, Integrated University Hospital and University of Verona, Verona, Italy.
Christian PagnouxDepartment of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France.ORCID https://orcid.org/0000-0001-6287-9549
Alexis RegentDepartment of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France.
Marc RuivardDepartment of Internal Medicine, Clermont-Ferrand University Hospital, Clermont-Ferrand, France.
Loïc GuillevinDepartment of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France.
Xavier PuéchalDepartment of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France.ORCID https://orcid.org/0000-0003-3573-9203
Benjamin TerrierDepartment of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France.
French Vasculitis Study Group (FVSG)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGranulomatosis with polyangiitis (GPA) and eosinophilic granulomatosis with polyangiitis (EGPA) are distinct forms of antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV). Increasing evidence suggests overlapping features, particularly in proteinase 3 (PR3)-ANCA-positive EGPA and GPA with eosinophilia. This study aimed to characterize overlapping EGPA/GPA forms and assess their clinical and therapeutic implications.

methodsWe conducted a European, multicenter, observational study, including 135 patients with overlapping EGPA/GPA features. Definitions were based on ACR/EULAR classification criteria and other clinical and biological findings. Clinical, biological, and histological characteristics were analyzed using unsupervised hierarchical clustering approach. Comparisons were made with established EGPA and GPA control cohorts.

resultsThree clusters emerged: Cluster 1, a hybrid phenotype (pulmonary nodules, PR3-ANCA positivity, high relapse rate); Cluster 2, a systemic inflammatory phenotype (constitutional symptoms, PR3-ANCA positivity, moderate renal involvement); and Cluster 3, a severe vasculitis form (severe renal disease, alveolar hemorrhage). Including typical EGPA and GPA control cohorts revealed two main clusters a posteriori: an EGPA cluster and a GPA cluster. Cluster 1 overlapped with both EGPA and GPA clusters, whereas Clusters 2 and 3 predominantly aligned with GPA. Kaplan-Meier analysis revealed that Cluster 1 and the typical EGPA cohort had the best overall survival, whereas Cluster 3 had the poorest survival. Relapse-free survival was highest in typical EGPA and poorest in Cluster 3 and typical GPA.

conclusionThis study delineates the heterogeneity of EGPA/GPA overlap and underscores the need for personalized treatment approaches. Future prospective studies should explore targeted therapies, including rituximab and IL-5 blockade, in these overlapping AAV subtypes.

Indexed as

Churg-Strauss SyndromeGranulomatosis with PolyangiitisAdultAgedAntibodies, Antineutrophil CytoplasmicEuropeFemaleHumansMaleMiddle AgedMyeloblastinPhenotypeAntibodies, Antineutrophil CytoplasmicMyeloblastinANCA‐associated vasculitideseosinophilic granulomatosis with polyangiitisgranulomatosis with polyangiitisoverlapping forms

Identifiers

PMID41366827
PMCPMC12869015

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.