Clinical characteristics and follow-up of 60 patients with recent diagnosis of giant cell arteritis, NEWTON study

The management of giant cell arteritis (GCA) has evolved with the arrival of tocilizumab (TCZ) and the use of PET/CT. Our objective is to describe the characteristics and followup of patients with recent diagnosis of GCA in current care. The NEWTON cohort is a monocentric retrospective cohort based...

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Veröffentlicht in:La revue de medecine interne 2024-06, Vol.45 (6), p.335-342
Hauptverfasser: Lomba Goncalves, N, Tran, V-T, Chauffier, J, Bourdin, V, Nassarmadji, K, Vanjak, A, Bigot, W, Burlacu, R, Champion, K, Lopes, A, Depont, A, Borrero, B A, Mangin, O, Adle-Biassette, H, Bonnin, P, Boutigny, A, Bonnin, S, Neumann, L, Mouly, S, Sène, D, Comarmond, C
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Zusammenfassung:The management of giant cell arteritis (GCA) has evolved with the arrival of tocilizumab (TCZ) and the use of PET/CT. Our objective is to describe the characteristics and followup of patients with recent diagnosis of GCA in current care. The NEWTON cohort is a monocentric retrospective cohort based on data collected from 60 GCA patients diagnosed between 2017 and 2022 according to the ACR/EULAR 2022 criteria. The median age at diagnosis was 73 [68.75; 81] years old. At diagnosis, the main manifestations were unusual temporal headaches in 48 (80 %) and an inflammatory syndrome in 50 (83 %) patients. Temporal artery biopsy confirmed the diagnosis in 49/58 (84 %) patients. Doppler of the temporal arteries found a halo in 12/23 (52 %) patients. The PET/CT found hypermetabolism in 19/43 (44 %) patients. Prednisone was stopped in 17.5 [12.75; 24.25] months. During follow-up, 22 (37 %) patients received TCZ. At least one complication of corticosteroid therapy was observed in 22 (37 %) patients. After a median follow-up of 24 [12; 42] months, 25 (42 %) patients relapsed. At the end of the follow-up, 29 (48.3 %) patients were weaned from corticosteroid therapy and 15 (25 %) were on TCZ. Despite the increasing use of TCZ in the therapeutic arsenal and of the PET/CT in the imaging tools of GCA patients, relapses and complications of corticosteroid therapy remain frequent, observed in more than a third of patients.
ISSN:1768-3122
DOI:10.1016/j.revmed.2023.12.005