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Large-vessel vasculitis

 

Comparison of biopsy-proven giant cell arteritis in North America and Southern Europe: a population-based study


1, 2, 3, 4, 5, 6, 7, 8, 9, 10

 

  1. Division of Rheumatology, Azienda Unita’ Sanitaria Locale IRCCS di Reggio Emilia, Italy.
  2. Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.
  3. Division of Rheumatology, Azienda Unita’ Sanitaria Locale IRCCS di Reggio Emilia, Italy.
  4. Department of Surgery, Medicine, Dentistry and Morphological Sciences with interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.
  5. Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  6. Division of Rheumatology, Azienda Unita’ Sanitaria Locale IRCCS di Reggio Emilia, Italy.
  7. Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
  8. Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, and Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.
  9. Division of Rheumatology, Azienda Unità Sanitaria Locale IRCCS di Reggio Emilia, and Department of Surgery, Medicine, Dentistry and Morphological Sciences with interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy. salvarani.carlo@ausl.re.it
  10. Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.

CER12808
2020 Vol.38, N°2 ,Suppl.124
PI 0079, PF 0083
Large-vessel vasculitis

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PMID: 32083546 [PubMed]

Received: 25/09/2019
Accepted : 25/11/2019
In Press: 11/02/2020
Published: 21/05/2020

Abstract

OBJECTIVES:
To compare clinical characteristics, treatment and prognosis of two population-based cohorts of patients with biopsy-proven giant cell arteritis (GCA) from Olmsted County, Minnesota, USA (Olmsted cohort) and the Reggio Emilia area, Northern Italy (Reggio cohort).
METHODS:
All patients residing in Olmsted County and the Reggio Emilia area with a new diagnosis of biopsy-proven GCA in 1986-2007 were retrospectively identified. Patients were followed from GCA diagnosis to death, migration or September 2011.
RESULTS:
The study included 110 patients in the Olmsted and 144 in the Reggio cohort. Compared with the Olmsted cohort, patients from the Reggio cohort had longer duration of symptoms prior to diagnosis (median 1.4 months vs. 0.7, p<0.001) and were younger (mean 74.6 years vs. 77.8, p=0.002), more likely to have cranial symptoms (93% vs. 86%, p=0.048), permanent vision loss (21% vs. 6%, p=0.001) and systemic symptoms (67% vs. 46%, p=0.001). ESR and CRP were higher (mean 88 mm/h vs. 73, and 89.0 mg/L vs. 35.2, both p<0.001) in the Reggio cohort. Patients from the Olmsted cohort received a higher initial prednisone dose (mean 53.6 mg/day vs. 49.5, p=0.001). There were no differences in relapse rates, cumulative glucocorticoid (GC) dosages at 1, 2 and 5 years, and time to first GC discontinuation.
CONCLUSIONS:
Geographical, genetic and/or environmental factors may contribute to the different clinical features at onset of GCA observed in this study.

Rheumatology Article