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

Authors :
Ségolène, Perrineau
Thibault, Ghesquière
Pierre, Charles
Romain, Paule
Maxime, Samson
Martine, Gayraud
Anthony, Chauvin
Benjamin, Terrier
Loic, Guillevin
Bernard, Bonnotte
Luc, Mouthon
Alexis, Régent
Source :
Clinical and Experimental Rheumatology. 39:155-160
Publication Year :
2021
Publisher :
Clinical and Experimental Rheumatology, 2021.

Abstract

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.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.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%. Age75 years, treatment duration2 years, past medical history of diabetes were risk factors associated with GC-related SEs.Flares occur in 41% of patients during GC withdrawal. As much as 64% of patients had treatment related SEs. An age75 year and a past medical history of diabetes were predictive of SEs during follow-up.

Details

ISSN :
1593098X and 0392856X
Volume :
39
Database :
OpenAIRE
Journal :
Clinical and Experimental Rheumatology
Accession number :
edsair.doi.dedup.....ec4c7289a5715e4ca3e07a1e88540bb5