{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:08:44Z","timestamp":1793225324624,"version":"4.5.0"},"reference-count":43,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Granulomatosis with polyangiitis (GPA) and eosinophilic granulomatosis with polyangiitis (EGPA) are distinct forms of antineutrophil cytoplasm antibody (ANCA)\u2010associated vasculitis (AAV). Increasing evidence suggests overlapping features, particularly in proteinase 3 (PR3)\u2010ANCA\u2010positive EGPA and GPA with eosinophilia. This study aimed to characterize overlapping EGPA\/GPA forms and assess their clinical and therapeutic implications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three clusters emerged: Cluster 1, a hybrid phenotype (pulmonary nodules, PR3\u2010ANCA positivity, high relapse rate); Cluster 2, a systemic inflammatory phenotype (constitutional symptoms, PR3\u2010ANCA 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\u2013Meier analysis revealed that Cluster 1 and the typical EGPA cohort had the best overall survival, whereas Cluster 3 had the poorest survival. Relapse\u2010free survival was highest in typical EGPA and poorest in Cluster 3 and typical GPA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This 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\u20105 blockade, in these overlapping AAV subtypes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/joim.70056","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T05:29:51Z","timestamp":1765344591000},"page":"349-364","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Overlapping forms of granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis: Insights from a European multicenter study"],"prefix":"10.1111","volume":"299","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7986-9190","authenticated-orcid":false,"given":"Federica","family":"Pallotti","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Cochin Hospital National Referral Center for Rare Systemic Autoimmune Diseases Paris University  Paris France"},{"name":"Department of 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