Glucocorticoid discontinuation rate and risk factors for relapses in a contemporary cohort of patients with giant cell arteritis.

Autor: Tsalapaki C; School of Medicine, General Hospital of Athens 'Hippokration', 2nd Department of Medicine and Laboratory, Clinical Immunology-Rheumatology Unit, National and Kapodistrian University of Athens, 114 Vass. Sophias Ave., 115 27, Athens, Greece., Lazarini A; General Hospital 'Asklepieio', Rheumatology Clinic, Athens, Greece., Argyriou E; General Hospital 'Sismanogleio', Rheumatology Clinic, Athens, Greece., Dania V; General Hospital 'Sismanogleio', Rheumatology Clinic, Athens, Greece., Boki K; General Hospital 'Sismanogleio', Rheumatology Clinic, Athens, Greece., Evangelatos G; General Hospital NIMTS, Rheumatology Clinic, Athens, Greece., Iliopoulos A; General Hospital NIMTS, Rheumatology Clinic, Athens, Greece., Pappa M; School of Medicine, General Hospital 'Laiko', 1st Department of Propedeutic Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece., Sfikakis PP; School of Medicine, General Hospital 'Laiko', 1st Department of Propedeutic Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece., Tektonidou MG; School of Medicine, General Hospital 'Laiko', 1st Department of Propedeutic Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece., Georgountzos A; General Hospital 'Gennimatas', Rheumatology Clinic, Athens, Greece., Kaltsonoudis E; University of Ioannina, Rheumatology Clinic, Ioannina, Greece., Voulgari P; University of Ioannina, Rheumatology Clinic, Ioannina, Greece., Drosos AA; University of Ioannina, Rheumatology Clinic, Ioannina, Greece., Theotikos E; General Hospital 'Asklepieio', Rheumatology Clinic, Athens, Greece., Papagoras C; First Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece., Dimitroulas T; 4th Department of Medicine, Aristotle University, Thessaloniki, Greece., Garyfallos A; 4th Department of Medicine, Aristotle University, Thessaloniki, Greece., Kataxaki E; Thriasio General Hospital, Rheumatology Clinic, Elefsina, Greece., Vosvotekas G; Thessaloniki, Greece., Boumpas D; School of Medicine, 4th Department of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece., Hadziyannis E; School of Medicine, General Hospital of Athens 'Hippokration', 2nd Department of Medicine and Laboratory, Clinical Immunology-Rheumatology Unit, National and Kapodistrian University of Athens, 114 Vass. Sophias Ave., 115 27, Athens, Greece., Vassilopoulos D; School of Medicine, General Hospital of Athens 'Hippokration', 2nd Department of Medicine and Laboratory, Clinical Immunology-Rheumatology Unit, National and Kapodistrian University of Athens, 114 Vass. Sophias Ave., 115 27, Athens, Greece. dvassilop@med.uoa.gr.
Jazyk: angličtina
Zdroj: Rheumatology international [Rheumatol Int] 2024 Apr; Vol. 44 (4), pp. 603-610. Date of Electronic Publication: 2024 Feb 01.
DOI: 10.1007/s00296-023-05527-8
Abstrakt: The rates of relapses and therapy discontinuation in patients with giant cell arteritis (GCA) in the modern therapeutic era have not been defined. We aimed to evaluate the glucocorticoid (GC) discontinuation rate and the factors associated with relapses in a contemporary GCA cohort. Patient and treatment data were collected cross-sectionally at first evaluation and 2 years later (second evaluation), in a multicenter, prospective GCA cohort. Predictors of relapses were identified by logistic regression analyses. 243 patients with GCA were initially included (67% women, mean age at diagnosis: 72.1 years, median disease duration: 2 years) while 2 years later complete data for 160 patients were available and analyzed. All patients had received GCs at diagnosis (mean daily prednisolone dose: 40 mg) while during follow-up, 37% received non-biologic and 16% biologic agents, respectively. At second evaluation, 72% of patients were still on therapy (GCs: 58% and/or GC-sparing agents: 29%). Relapses occurred in 27% of patients during follow-up; by multivariable logistic regression analysis, large vessel involvement at diagnosis [odds ratio (OR) = 4.22], a cardiovascular event during follow-up (OR = 4.60) and a higher initial GC daily dose (OR = 1.04), were associated with these relapses. In this large, real-life, contemporary GCA cohort, the rates of GC discontinuation and relapses were 40% and 27%, respectively. Large vessel involvement, a higher GC dose at diagnosis and new cardiovascular events during follow-up were associated with relapses.
(© 2024. The Author(s).)
Databáze: MEDLINE
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