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Giant cell arteritis (GCA) is a type of inflammation affecting the walls of the large and medium vessels. It affects adults over the age of 50. Headaches, weight loss, fatigue, fever and biological inflammatory syndrome are the usual manifestations. Severe complications can occur. Glucocorticoids therapy constitutes the cornerstone of treatment, but can lead to many complications in case of prolonged usage. The aim of this work was to make an assessment of the individual risk of morbidity related to GCA drawing on published data, described evolution of mortality via EUROSTAT registry and to evaluate the relative interest in terms of efficacy and tolerance of the steroid-sparing molecules currently available. A review of the literature regarding CGA was performed. The prevalence of relapses was estimated using meta-analysis. 34 studies were included with a total of 2,505 patients. Pooled prevalence was estimated to be 47.2% (95% confidence interval [CI] 40.0 – 54.3), with strong heterogeneity (I²=93%). The prevalence of relapses was significantly higher in the randomized trials compared to the observational studies (65.8% versus 41.7%, p, L’artérite à cellules géantes (ACG) est une inflammation des parois des gros et moyens vaisseaux et concerne les adultes de plus de 50 ans. Elle se manifeste par des céphalées, une altération de l’état général et un syndrome inflammatoire biologique. Des complications sévères peuvent survenir. La corticothérapie est la pierre angulaire du traitement, mais entraîne de nombreuses complications lors d’une prise prolongée. L’objectif de ce travail était de faire l’état des lieux de la morbi-mortalité de la pathologie, à partir des données publiées, et des données de mortalité disponibles via EUROSTAT ; d’évaluer l’intérêt relatif en terme d’efficacité et de tolérance des molécules à visée d’épargne cortisonique actuellement disponibles. Une revue de la littérature de l’ACG a été réalisée. La prévalence des rechutes a été estimée par des techniques méta-analytiques. 34 études ont été inclues totalisant 2 505 patients. La prévalence globale était estimée à 47,2% (intervalle de confiance (IC) à 95% 40,0 – 54,3), avec une forte hétérogénéité (I²=93%). La prévalence des rechutes était significativement plus haute dans les essais randomisés par rapport aux études observationnelles (65,8% versus 41,7%, p

Introduction: corticoid administration is the usual treatment of Crohn' disease (CD) and ulcerative colitis (UC) attacks. How-ever, information available on response rates and their predictive factors is scarce. Objective: to establish response to steroidal treatment in an homogeneous group of patients with CD or UC during their first admission to hospital. Methods: restrospective analysis of 86 patients who received systemic steroidal treatment for a severe flare-up during their first hospital admission between 1995 and 2000. Patients were treated per protocol with fluid therapy, absolute diet, IV 6-methyl-prednisolone 1 mg/kg/day, and enoxaparin at prophylactic doses. Clinical response at 30 days was considered good in case of complete remission, and poor in case of partial or absent remission. Univariate and multivariate analyses according to non-parametric statistics were performed for sociodemographic and biologic variables. Results: 45 patients with CD and 41 with UC were included. Good response rates were 64.4% for CD and 60.9% for UC. The univariate analysis showed that patients with good response have shorter evolution times and fewer previous flare-ups (p < 0.05) regarding CD. However, the multivariate analysis showed that none of the analyzed variables had predictive value. Conclusion: the response rate of severe inflammatory bowel disease attacks to corticoids is around 60% in CD and UC. Data resulting from the current study cannot predict which patients will ultimately respond to therapy.

Introduction: corticoid administration is the usual treatment of Crohn' disease (CD) and ulcerative colitis (UC) attacks. How-ever, information available on response rates and their predictive factors is scarce. Objective: to establish response to steroidal treatment in an homogeneous group of patients with CD or UC during their first admission to hospital. Methods: restrospective analysis of 86 patients who received systemic steroidal treatment for a severe flare-up during their first hospital admission between 1995 and 2000. Patients were treated per protocol with fluid therapy, absolute diet, IV 6-methyl-prednisolone 1 mg/kg/day, and enoxaparin at prophylactic doses. Clinical response at 30 days was considered good in case of complete remission, and poor in case of partial or absent remission. Univariate and multivariate analyses according to non-parametric statistics were performed for sociodemographic and biologic variables. Results: 45 patients with CD and 41 with UC were included. Good response rates were 64.4% for CD and 60.9% for UC. The univariate analysis showed that patients with good response have shorter evolution times and fewer previous flare-ups (p < 0.05) regarding CD. However, the multivariate analysis showed that none of the analyzed variables had predictive value. Conclusion: the response rate of severe inflammatory bowel disease attacks to corticoids is around 60% in CD and UC. Data resulting from the current study cannot predict which patients will ultimately respond to therapy. Introducción: la administración de corticoides constituye el tratamiento habitual de los brotes de enfermedad de Crohn (EC) y colitis ulcerosa (CU). Sin embargo, existe poca información sobre las tasas de respuesta y los factores que puedan predecirla. Objetivo: determinar la respuesta al tratamiento esteroideo en un grupo homogéneo de pacientes de EC y CU que ingresan por primera vez en el hospital. Métodos: análisis retrospectivo de 86 pacientes que en su primer ingreso hospitalario recibieron tratamiento esteroideo sistémico por brote grave de EC o CU entre 1995 y 2000. Fueron tratados de forma protocolizada con sueroterapia, dieta absoluta, 6-metil-prednisolona 1 mg/kg/día IV y enoxaparina a dosis profilácticas. Se ha considerado la respuesta clínica a los 30 días como buena en caso de remisión completa o mala si la remisión es parcial o ausente. Se realizó estudio univariado y multivariado según estadística no paramétrica de diferentes variables sociodemográficas y biológicas. Resultados: se han incluido 45 pacientes con EC y 41 con CU. La tasa de buena respuesta fue del 64,4% en la EC y del 60,9% en la CU. El análisis univariado demostró que los pacientes con buena respuesta tienen un tiempo de evolución más corto y un menor número de brotes previos (p < 0,05) para la EC. Sin embargo, el análisis multivariado no demostró que alguna variable de las analizadas tuviera valor predictivo. Conclusión: la respuesta de los brotes graves de enfermedad inflamatoria intestinal a los corticoides es alrededor del 60% en la EC y CU. Los datos del presente estudio no permiten predecir qué pacientes son los que responderán al tratamiento.