Brief observationGiant-Cell Arteritis: Do We Treat Patients with Large-Vessel Involvement Differently?
Section snippets
Study Design and Patients
For this study, we used the cohort previously reported (which grew, up from 130 to 173 patients). Briefly, all patients had a diagnosis of giant-cell arteritis and underwent a PET/CT at diagnosis or during the follow-up.2 Patients were followed up between 2005 and 2015 in 3 West-French teaching hospitals and reference centers for giant-cell arteritis (Caen, Limoges, and Lille University Hospitals). To be included in this study, 1) patients had to fulfill at least 3 of the 5 American College
Patient Description
We included 80 patients (50 women/30 men, median age 71 [53-87] years) in the present study, including 40 who had large-vessel involvement at diagnosis and 40 who did not. Detailed clinical manifestations and biological parameters of included patients at diagnosis are shown in Table 1. A median of 4 [2-8] vascular territories were involved on positive PET/CT (detail in Table 2).
Therapeutic Strategies and Outcomes
The comparative treatment and outcomes of both groups are shown in Table 3. Although patients with and without
Discussion
In this study, we reported the results of a retrospective audit of the medical practices used in 3 tertiary care university centers regarding the empirical treatment of newly diagnosed giant-cell arteritis with and without large-vessel involvement. We observed that the detection of large-vessel involvement at diagnosis had no influence on the initial therapeutic strategy in the studied physician panel and the initial GC doses were not different between the groups. Furthermore, subgroup analysis
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Cited by (27)
Clinical phenotype and complications of large vessel giant cell arteritis: A systematic review and meta-analysis
2023, Revue du Rhumatisme (Edition Francaise)Disease stratification in giant cell arteritis to reduce relapses and prevent long-term vascular damage
2021, The Lancet RheumatologyRisk profiling for a refractory course of giant cell arteritis: The importance of age and body weight: “Risk profiling for GC resistance in GCA”
2020, Seminars in Arthritis and RheumatismCitation Excerpt :Whether the presence of aortitis and other large artery involvements has an impact on therapeutic issues is disputed. Four studies have found an association between aortic involvement and a more protracted GCA course [25,38–40], whereas three have not found any [41–43]. Notably, two of the latter studies had only focused on the results of ultrasound scans [42,43].
The current place of non-invasive large-vessel imaging in the diagnosis and follow-up of giant cell arteritis
2020, Revue de Medecine InterneRelapses and long-term remission in large vessel giant cell arteritis in northern Italy: Characteristics and predictors in a long-term follow-up study
2020, Seminars in Arthritis and RheumatismCitation Excerpt :Evaluation of LV involvement with systematic radiographic imaging in patients with newly diagnosed GCA demonstrated the presence of LV disease in 29-83% of patients, depending on the sensitivity for detecting vascular inflammation of the imaging technique used [5–11]. Patients with LV-GCA have a lower prevalence of positive temporal artery biopsy (TAB), furthermore they have a different clinical presentation compared to those with cranial GCA (C-GCA) with more common polymyalgia rheumatica (PMR) and less frequent cranial symptoms and vision loss and also different outcomes with a higher relapse rate and greater glucocorticoid (GC) requirements [12–16]. GCs are the treatment of choice for GCA; adequate doses quickly suppress clinical manifestations of GCA and mostly prevent ischemic complications [1–3].
Funding: None.
Conflict of Interest: None.
Authorship: All authors had access to the data and a role in writing the manuscript.