Role of systemic immunosuppression on subglottic stenosis in granulomatosis with polyangiitis: Analysis of a single-centre cohort

•Subglottic stenosis (SGS) in GPA occurs more frequently in younger patients.•Systemic immunosuppression reduces the risk of SGS relapse in GPA patients.•RTX and CYC show a protective role against subsequent dilation procedures.•In generalised disease, higher steroid doses are associated with delayed SGS relapse. Subglottic stenosis (SGS) is a potentially life-threatening manifestation of granulomatosis with polyangiitis (GPA). Endoscopic dilation is effective, but relapses are frequent and the benefit of systemic immunosuppression in this setting is still controversial. We aimed to investigate the role of immunosuppressive treatment on SGS relapse risk. This is a retrospective observational study based on review of medical charts among our cohort of patients with GPA. Twenty-one patients with SGS-GPA were identified, with a prevalence of 20% among our entire GPA cohort (n = 105). Compared to patients without SGS, patients with SGS-GPA had an earlier disease onset (mean age 30.2 vs. 47.3 years, p