Gene G. Hunder, MD, professor emeritus of the Mayo Clinic in Rochester, Minn., has also shared a lifelong interest in the vasculidities. “The vascular inflammatory diseases were always thought to be uncommon, and studies on them languished,” he notes. Dr. Bacon’s work in developing a disease activity index contributed to advances in treatments, since the indices made possible the comparison of outcomes using common criteria.
What had originally sparked Dr. Bacon’s interest in developing a vasculitis index was not just the number of cases he and his recruits saw in their clinics. Discussion with his nephrology colleagues, who were also seeing disease, made him question their assumption that the kidney was the most important organ to assess. He and Raashid Luqmani, DM, a consultant rheumatologist at the University of Oxford in Oxford, U.K., and another leading figure in vasculitis research, compared disease severity in patients presenting with airways vasculitis with a group presenting with renal vasculitis, and found that the morbidity and mortality were similar. After those findings, he and Dr. Luqmani assembled a study group and persuaded the nephrologists to collaborate to develop a disease activity index that scores organ involvement in a total of 10 categories.
First published in 1994, the BVAS attracted the attention of European researchers, who were looking for an index to measure disease activity in order to compare outcomes in clinical vasculitis trials.1 Although he characterized the initial creation of BVAS, in concert with nephrologists, as “one of the most difficult things I’ve ever done,” Dr. Bacon was also challenged by the European Vasculitis Study Group to refine and improve the definitions to better serve the group and its studies. Further work by his colleagues in Paris (including Dr. Guillevin) showed that using the BVAS to assess patients at presentation could also predict prognosis and mortality.
“In this phase of the ‘third wave,’ Dr. Bacon, together with Raashid Luqmani, was very productive,” says Dr. Gross. “Dr. Bacon is a very impressive person. Always, in discussion, he was a really keen thinker and he made very clear statements.”
Dr. Guillevin agrees, saying “[Dr. Bacon] is a very good chairman because his questions are very useful and stimulating. He was also one of the first people to think of [the association] of arteriosclerosis in vasculitis. He is like a machine, making new projects and new ideas all the time.”
1966–Becomes research fellow and registrar at Kennedy Institute of Rheumatology