Large vessel vasculitis is a risk factor for relapse only in giant cell arteritis patients without polymyalgia rheumatica.

Autor:	Moreel L; Department of General Internal Medicine, UZ Leuven, Leuven, Belgium.; Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium., Betrains A; Department of General Internal Medicine, UZ Leuven, Leuven, Belgium.; Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium., Boeckxstaens L; Department of Nuclear Medicine, UZ Leuven, Leuven, Belgium.; Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, Leuven, KU, Belgium., Molenberghs G; Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BioStat), KU Leuven and Hasselt University, Leuven, Belgium., Van Laere K; Department of Nuclear Medicine, UZ Leuven, Leuven, Belgium.; Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, Leuven, KU, Belgium., De Langhe E; Department of Rheumatology, UZ Leuven, Leuven, Belgium.; Department of Development and Regeneration, KU Leuven, Leuven, Belgium.; European Reference Network for Immunodeficiency, Autoinflammatory, Autoimmune and Pediatric Rheumatic disease (ERN-RITA)., Vanderschueren S; Department of General Internal Medicine, UZ Leuven, Leuven, Belgium.; Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium.; European Reference Network for Immunodeficiency, Autoinflammatory, Autoimmune and Pediatric Rheumatic disease (ERN-RITA)., Blockmans D; Department of General Internal Medicine, UZ Leuven, Leuven, Belgium.; Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium.; European Reference Network for Immunodeficiency, Autoinflammatory, Autoimmune and Pediatric Rheumatic disease (ERN-RITA).
Jazyk:	angličtina
Zdroj:	Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2024 Aug 22. Date of Electronic Publication: 2024 Aug 22.
DOI:	10.1093/rheumatology/keae456
Abstrakt:	Objectives: To evaluate differences in presentation and outcome of giant cell arteritis (GCA) patients with and without large vessel vasculitis (LVV) and according to the extent and severity of LVV. Methods: Consecutive patients diagnosed with GCA between 2003 and 2020 who have had FDG PET imaging at diagnosis ≤3 days after initiation of glucocorticoids and followed for ≥12 months at the University Hospitals Leuven (Belgium), were included retrospectively. PET scans were visually scored (0-3) in 7 vascular areas and a total vascular score (TVS) was calculated. LVV was defined as FDG uptake ≥2 in any large vessel. Results: We included 238 GCA patients, of which 169 (71%) had LVV. LVV patients were younger (69 vs 74 years, p< 0.001) and more frequently female (72% vs 49%, p= 0.001). In patients without PMR symptoms, the presence of LVV was associated with relapse (aOR 3.05 [95%CI 1.32-7.43], p= 0.011) and with a lower probability of stopping glucocorticoids (aHR 0.59 [95%CI 0.37-0.94], p= 0.025). However, in those with PMR symptoms, there was no difference in relapse risk (aOR 1.20 [95%CI 0.53-2.66], p= 0.657) and in the probability of stopping glucocorticoids (aHR 1.25 [95%CI 0.75-2.09], p= 0.394) between patients with and without LVV. A higher TVS was associated with an increased risk of relapse (aOR 1.09 [95%CI 1.04-1.15], p= 0.001] in patients without PMR symptoms, but not in those with PMR symptoms (aOR 1.01 [95%CI 0.96-1.07], p= 0.693). Conclusion: LVV is a risk factor for relapse in GCA patients without PMR symptoms with a higher relapse risk in those with higher TVS. (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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