Year: 2024
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: The objectives of this study were to evaluate the frequency and timing of sustained drug-free remission (SDFR) in patients with GCA and to identify potential predictive factors of this outcome. METHODS: A retrospective review of all patients included in the large Spanish multicentre registry for GCA (ARTESER) with at least 2 years of follow-up was undertaken. SDFR was defined as the absence of typical signs, symptoms, or other features of active GCA for ≥12 months after discontinuation of treatment. RESULTS: We included 872 patients. Forty-seven percent had received concomitant treatment with tocilizumab and/or immunosuppressants, mainly MTX. SDFR was achieved in 21.2% (185/872) of the patients. The cumulative rates of patients achieving SDFR at 2, 3 and 4 years were 6.3%, 20.5% and 25.3%, respectively. Patients who achieved SDFR could reduce their prednisone dosage to 10 mg/day (P = 0.090) and 5 mg/day (P = 0.002) more quickly than those who did not. Relapses were less frequent in patients with SDFR (P = 0.006). The presence of relapses [incident rate ratio (IRR): 0.492, P < 0.001] and the need for i.v. methylprednisolone boluses at diagnosis (IRR: 0.575, P = 0.003) were significantly associated with a decreased likelihood of achieving SDFR. Only 5 patients (2.7%) experienced a recurrence, with a median onset of 19 months after achieving SDFR (interquartile range 25th-75th: 14-35 months). CONCLUSION: Within 3-4 years of diagnosis, only one-quarter of patients with GCA successfully reached the SDFR. Once the SDFR was achieved, the likelihood of experiencing recurrence was low. Relapses and the need for glucocorticoid boluses appear to have been predictors of the need for long-term glucocorticoids.
Source: Lara D. Veeken
Authors: Javier Narváez, Marta Domínguez-Álvaro, Eva Galíndez-Agirregoikoa, Javier Mendizábal, Lydia Abasolo, Judit Lluch, Javier Loricera, Noemí Garrido, Santos Castañeda, Patricia Moya Alvarado, Carmen Larena, Paula Estrada, Carlos Galisteo, Anne Riveros Frutos, Francisco Ortiz Sanjuán, Tarek C Salman Monte, Margarida Vasques Rocha, Carlota L Iñiguez, María García-Gonzalez, Ricardo Blanco, ARTESER Project Collaborative Group, Clara Moriano Morales, Ismael González Fernández, Elvira Díez Álvarez, Trinidad Pérez Sandoval, Vicente Aldasoro Cáceres, María Concepción Fito Manteca, Natividad del Val del Amo, Loreto Horcada Rubio, Inmaculada Paniagua Zudaire, Laura Garrido Courel, Ricardo Gutiérrez Polo, Juliana Restrepo Vélez, Eduardo Loza Cortina, Julio Sánchez Martín, Patricia Carreira, Tomás Almorza, Leticia León Mateos, Luis Rodríguez Rodríguez, Judit Font Urgelles, Pia Mercedes Lois Bermejo, Benjamín Fernández Gutiérrez, Selene Labrada Arrabal, Ivette Casafont, Susana Holgado Pérez, Jordi Camins, Clara Molina Almela, Cristina Campos Fernández, Amalia Rueda Cid, Javier Calvo Catalá, Iñigo Hernández Rodríguez, Rafael Melero, Francisco Maceiras, Nair Pérez, Ceferino Barbazán, Jose María Pego, Irene Altabás, John Guzmán, Vanessa Andrea Navarro Angeles, Héctor Corominas, Iván Castellví, Berta Magallares, Ana Milena Millán, María Alcalde Villar, Ana F Cruz Valenciano, Félix Cabero del Pozo, Ana Belén Rodríguez Cambrón, Cristina Macia Villa, Eva Álvarez de Andrés, Antonio Juan Mas, Inmaculada Ros Vilamajó, Monica Ibáñez Barceló, Elide Toniolo, Ana Paula Cacheda, María Sagrario Bustabad Reyes, Alicia García Dorta, Vanesa Hernández, Jaime Calvo Allen, Eugenio de Miguel Mendieta, Elisa Fernández-Fernández, Irene Monjo Henri, Noelia García, Cristina Valero Martínez, Esther F Vicente Rabaneda, Carlos García Porrúa, Noelia Álvarez Rivas, Tomás Ramón Vázquez Rodríguez, Jose Alberto Miranda Filloy, Amalia Sánchez-Andrade Fernández, Miguel Ángel González-Gay, Joan Calvet Fontova, María Jesús García Villanueva, Patricia Morán Álvarez, Marina Tortosa Cabañas, Marta Serrano Warleta, Aliuska Palomeque Vargas, Clara Aguilera Cros, Alejandro Muñoz Jimenez, Alberto Ruiz Román, Jose A Román Ivorra, Carmen Riesco Bárcena, Anderson Huaylla, Itziar Calvo Zorrilla, Joaquín María Belzunegui, Jesús A Valero-Jaimes, Luis López Domínguez, Cesar Antonio Egues Dubuc, Maite Silva-Diaz, Lucia Silva Fernández
Institutions: Bellvitge University Hospital, Institut d'Investigació Biomédica de Bellvitge, Sociedad Española de Reumatología, Hospital de Basurto, Complejo Hospitalario de Navarra, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Marqués de Valdecilla University Hospital, Instituto de Investigación Marqués de Valdecilla, Hospital Universitario Virgen del Rocío, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Hospital de Sant Pau, Hospital Universitario Ramón y Cajal, Hospital de Sant Joan Despí Moisès Broggi, Universitat de Barcelona, Corporació Sanitària Parc Taulí, Hospital Universitari Germans Trias i Pujol, Hospital Universitari i Politècnic La Fe, Hospital Del Mar, Hospital Universitario Araba, Hospital Universitario Lucus Augusti, Hospital Universitario de Canarias
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4404742291