Sustained Drug-Free Remission in Giant Cell Arteritis

To evaluate the frequency and timing of sustained drug-free remission (SDFR) in patients with giant cell arteritis (GCA) and to identify potential predictive factors of this outcome. Retrospective review of all patients included in the large Spanish multicentre registry for GCA (ARTESER) with at least two years of follow-up. SDFR was defined as the absence of typical signs, symptoms, or other features of active GCA for ≥12 months after discontinuation of treatment. We included 872 patients. Forty-seven percent had received concomitant treatment with tocilizumab and/or immunosuppressants, mainly methotrexate.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: 0.492, p