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A French cohort of patients with giant cell arteritis: glucocorticoid treatment and its associated side effects


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12

 

  1. Department of Internal Medicine, Hôpital Cochin, Université de Paris, Sorbonne Paris Cité, INSERM Unité 1016, Centre de Référence pour les Maladies Auto-immunes Rares, Paris, France.
  2. Department of Internal Medicine and Clinical Immunology, François Mitterrand Hospital, Dijon University Hospital, Dijon, France.
  3. Department of Internal Medicine, Institut Mutualiste Montsouris, Paris, France.
  4. Department of Internal Medicine, Hôpital Cochin, Université de Paris, Sorbonne Paris Cité, INSERM Unité 1016, Centre de Référence pour les Maladies Auto-immunes Rares, Paris, France.
  5. Department of Internal Medicine and Clinical Immunology, François Mitterrand Hospital, Dijon University Hospital, Dijon, France.
  6. Department of Internal Medicine, Institut Mutualiste Montsouris, Paris, France.
  7. METHODS Team, Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité (CRESS UMR 1153), INSERM, Paris, Île-de-France, and Emergency Department, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France; Faculté de Médecine, Université Diderot, Paris, France.
  8. Department of Internal Medicine, Hôpital Cochin, Université de Paris, Sorbonne Paris Cité, INSERM Unité 1016, Centre de Référence pour les Maladies Auto-immunes Rares, Paris, and Institut Cochin, INSERM U1016, CNRS UMR 8104, Paris, France.
  9. Department of Internal Medicine, Hôpital Cochin, Université de Paris, Sorbonne Paris Cité, INSERM Unité 1016, Centre de Référence pour les Maladies Auto-immunes Rares, Paris, France.
  10. Department of Internal Medicine and Clinical Immunology, François Mitterrand Hospital, Dijon University Hospital, Dijon, France.
  11. Department of Internal Medicine, Hôpital Cochin, Université de Paris, Sorbonne Paris Cité, INSERM Unité 1016, Centre de Référence pour les Maladies Auto-immunes Rares, Paris, and Institut Cochin, INSERM U1016, CNRS UMR 8104, Paris, France.
  12. Department of Internal Medicine, Hôpital Cochin, Université de Paris, Sorbonne Paris Cité, INSERM Unité 1016, Centre de Référence pour les Maladies Auto-immunes Rares, Paris, and Institut Cochin, INSERM U1016, CNRS UMR 8104, Paris, France. alexis.regent@aphp.fr

for the French Vasculitis Study Group (FVSG)

CER14512
2021 Vol.39, N°2 ,Suppl.129
PI 0155, PF 0160
Treatment

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PMID: 33938796 [PubMed]

Received: 10/02/2021
Accepted : 16/04/2021
In Press: 30/04/2021
Published: 19/05/2021

Abstract

OBJECTIVES:
Giant cell arteritis (GCA) is the most common primary large-vessel vasculitis. Glucocorticoids (GC) therapy remains the standard of care for GCA despite frequent side effects (SEs). However, treatment modality changes, prophylactic treatment of osteoporosis, or vaccinations might have decreased the frequency of GC-related SEs. This study aims to describe GCA treatment and GC-related SEs in a recent cohort.
METHODS:
Patients with a diagnosis of GCA between May 2009 and March 2018 were included in this multicentric retrospective study. Characteristics of patients, treatment modalities and GC-related SEs were collected and analysed. Risk factors associated with the occurrence of SE were studied.
RESULTS:
We analysed the files from 206 patients (153 women, 53 men; median age 74 years). Median follow-up was 34 months. Patients received GC for a median of 25 months, starting at 0.7 mg/kg/day, with tapering to 5 mg/day after 11 months follow-up. Flares occurred in 83/201 (41%) patients. Among the 132 patients who stopped GC, 29 (22%) experienced a relapse. SEs occurred in 129 (64%) patients: bone fractures and infections in 13% each and hypertension onset in 9%. Age >75 years, treatment duration >2 years, past medical history of diabetes were risk factors associated with GC-related SEs.
CONCLUSIONS:
Flares occur in 41% of patients during GC withdrawal. As much as 64% of patients had treatment related SEs. An age> 75 year and a past medical history of diabetes were predictive of SEs during follow-up.

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