SAT0526 Is relapse rate of giant cell arteritis in real-life experience lower than in the controlled trials? results of a retrospective, multi-centre cohort study
| Autor: | O.N. Pamuk, Z Ertürk, Fatma Alibaz-Oner, Berkan Armagan, Emel Gönüllü, Mehmet Ali Balcı, Timuçin Kaşifoğlu, Mustafa Ferhat Öksüz, Cemal Bes, Orhan Küçükşahin, Ediz Dalkilic, Ayten Yazici, Murat Taşçı, Ali Ugur Unal, Ahmet Omma, Ozun Bayindir, Ayse Cefle, Gökhan Keser, Kenan Aksu, Atalay Dogru, Senol Yavuz, Mehmet Engin Tezcan, S. Yasar Bilge, O. Zengin, Haner Direskeneli, Omer Karadag |
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| Rok vydání: | 2018 |
| Předmět: |
030203 arthritis & rheumatology
medicine.medical_specialty business.industry Abatacept Mortality rate Azathioprine Retrospective cohort study medicine.disease Etanercept 03 medical and health sciences Giant cell arteritis chemistry.chemical_compound 0302 clinical medicine Tocilizumab chemistry Internal medicine medicine 030212 general & internal medicine business medicine.drug Cohort study |
| Zdroj: | Saturday, 16 JUNE 2018. |
| DOI: | 10.1136/annrheumdis-2018-eular.3983 |
| Popis: | Objectives Corticosteroids (CS) are accepted as the standard first-line treatment for giant cell arteritis (GCA). However, controlled trials of tocilizumab and abatacept demonstrated relapse rates of up to 70%–80% in patients on CS-only protocols in 12–24 months. Though level of evidence is low and not suggested by guidelines (except for methotrexate), conventional immunosuppressives (ISs) are also commonly used. We aimed to assess the relapse rates in patients with GCA in routine practice, retrospectively. Methods We assembled a retrospective cohort of patients with GCA from Turkey. All data was abstracted from records. Relapse was defined as any new manifestation or increased acute-phase response leading to the change of the CS dose or use of a new therapeutic agent by the treating physician. Results The study included 156 (F/M: 95/61) patients with GCA (table 1). The mean age at disease onset was 67.8±9.1 years. Polimyalgia Rheumatica was also present in 48 (30,8%) patients. Diagnosis was proven histopathologically in 99 patients.All patients received 1 mg/kg/day CS for remission induction, additional CS pulses were given to 36 (23.1%) patients. Conventional ISs including methotrexate and azathioprine were used in 89 (56.1%) and 26 (16.6%) patients respectively, while 10 (6.4%) patients received biologic treatments (8 tocilizumab,2 etanercept). Fourty-four (28.2%) patients used only CS during follow-up. Follow-up of at least 6 months was available for 132 patients, and median follow-up duration was 35 (6–268) months. Relapses occurred in 27 (20.5%) patients during follow-up. Mortality rate was 7.5% (n=10) during follow-up. VDI score was 2.4±1.7. Main causes of damage were related to CS treatments such as cataract, osteoporosis and diabetes mellitus. Conclusions In this first multi-centre series of GCA from Turkey, we observed that only one fifth of patients had relapses during a mean follow-up of 35 months. This lower relapse frequency suggests a different clinical spectrum in routine practice compared to patients included in controlled trials. Our results also suggest that there is a clear need for a steroid sparing agent in patients with GCA, that is a older aged population prone to CS side effects. Disclosure of Interest None declared |
| Databáze: | OpenAIRE |
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