Arterial lesions in giant cell arteritis: A longitudinal study

for the Vasculitis Clinical Research Consortium

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives: To evaluate large-vessel (LV) abnormalities on serial imaging in patients with giant cell arteritis (GCA) and discern predictors of new lesions. Methods: Clinical and imaging data from patients with GCA (including subjects diagnosed by LV imaging) enrolled in a prospective, multicenter, longitudinal study and/or a randomized clinical trial were included. New arterial lesions were defined as a lesion in a previously unaffected artery. Results: The study included 187 patients with GCA, 146 (78%) female, mean (±SD) age at diagnosis 68.5 ± 8.5 years; 39% diagnosed by LV imaging. At least one arterial lesion was present in 123 (66%) on the first study. The most frequently affected arteries were subclavian (42%), axillary (32%), and thoracic aorta (20%). In 106 patients (57%) with serial imaging, new arterial lesions were noted in 41 patients (39%), all of whom had a baseline abnormality, over a mean (±SD) follow-up of 4.39 (2.22) years. New abnormalities were observed in 33% patients by year 2; clinical features of active disease were present at only 50% of these cases. There were no differences in age, sex, temporal artery biopsy positivity, or disease activity in patients with or without new lesions. Conclusions: In this cohort of patients with GCA, LV abnormalities on first imaging were common. Development of new arterial lesions occurred in patients with arterial abnormalities at first imaging, often in the absence of symptoms of active disease. Arterial imaging should be considered in all patients with GCA at diagnosis and serial imaging at least in patients with baseline abnormalities.

Original languageEnglish (US)
JournalSeminars in Arthritis and Rheumatism
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Giant Cell Arteritis
Longitudinal Studies
Temporal Arteries
Subclavian Artery
Thoracic Aorta
Multicenter Studies
Randomized Controlled Trials
Arteries

Keywords

  • Aortic aneurysm
  • Computed tomography angiography
  • Disease activity
  • Giant cell arteritis
  • Large-artery stenosis
  • Magnetic resonance angiography

ASJC Scopus subject areas

  • Rheumatology
  • Anesthesiology and Pain Medicine

Cite this

Arterial lesions in giant cell arteritis : A longitudinal study. / for the Vasculitis Clinical Research Consortium.

In: Seminars in Arthritis and Rheumatism, 01.01.2018.

Research output: Contribution to journalArticle

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title = "Arterial lesions in giant cell arteritis: A longitudinal study",
abstract = "Objectives: To evaluate large-vessel (LV) abnormalities on serial imaging in patients with giant cell arteritis (GCA) and discern predictors of new lesions. Methods: Clinical and imaging data from patients with GCA (including subjects diagnosed by LV imaging) enrolled in a prospective, multicenter, longitudinal study and/or a randomized clinical trial were included. New arterial lesions were defined as a lesion in a previously unaffected artery. Results: The study included 187 patients with GCA, 146 (78{\%}) female, mean (±SD) age at diagnosis 68.5 ± 8.5 years; 39{\%} diagnosed by LV imaging. At least one arterial lesion was present in 123 (66{\%}) on the first study. The most frequently affected arteries were subclavian (42{\%}), axillary (32{\%}), and thoracic aorta (20{\%}). In 106 patients (57{\%}) with serial imaging, new arterial lesions were noted in 41 patients (39{\%}), all of whom had a baseline abnormality, over a mean (±SD) follow-up of 4.39 (2.22) years. New abnormalities were observed in 33{\%} patients by year 2; clinical features of active disease were present at only 50{\%} of these cases. There were no differences in age, sex, temporal artery biopsy positivity, or disease activity in patients with or without new lesions. Conclusions: In this cohort of patients with GCA, LV abnormalities on first imaging were common. Development of new arterial lesions occurred in patients with arterial abnormalities at first imaging, often in the absence of symptoms of active disease. Arterial imaging should be considered in all patients with GCA at diagnosis and serial imaging at least in patients with baseline abnormalities.",
keywords = "Aortic aneurysm, Computed tomography angiography, Disease activity, Giant cell arteritis, Large-artery stenosis, Magnetic resonance angiography",
author = "{for the Vasculitis Clinical Research Consortium} and Kermani, {Tanaz A.} and Sehriban Diab and Sreih, {Antoine G.} and David Cuthbertson and Ren{\'e}e Borchin and Simon Carette and Lindsy Forbess and Koening, {Curry L.} and McAlear, {Carol A.} and Monach, {Paul A.} and Larry Moreland and Christian Pagnoux and Philip Seo and Spiera, {Robert F.} and Warrington, {Kenneth J} and Ytterberg, {Steven R} and Langford, {Carol A.} and Merkel, {Peter A.} and Khalidi, {Nader A.}",
year = "2018",
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doi = "10.1016/j.semarthrit.2018.05.002",
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TY - JOUR

T1 - Arterial lesions in giant cell arteritis

T2 - A longitudinal study

AU - for the Vasculitis Clinical Research Consortium

AU - Kermani, Tanaz A.

AU - Diab, Sehriban

AU - Sreih, Antoine G.

AU - Cuthbertson, David

AU - Borchin, Renée

AU - Carette, Simon

AU - Forbess, Lindsy

AU - Koening, Curry L.

AU - McAlear, Carol A.

AU - Monach, Paul A.

AU - Moreland, Larry

AU - Pagnoux, Christian

AU - Seo, Philip

AU - Spiera, Robert F.

AU - Warrington, Kenneth J

AU - Ytterberg, Steven R

AU - Langford, Carol A.

AU - Merkel, Peter A.

AU - Khalidi, Nader A.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objectives: To evaluate large-vessel (LV) abnormalities on serial imaging in patients with giant cell arteritis (GCA) and discern predictors of new lesions. Methods: Clinical and imaging data from patients with GCA (including subjects diagnosed by LV imaging) enrolled in a prospective, multicenter, longitudinal study and/or a randomized clinical trial were included. New arterial lesions were defined as a lesion in a previously unaffected artery. Results: The study included 187 patients with GCA, 146 (78%) female, mean (±SD) age at diagnosis 68.5 ± 8.5 years; 39% diagnosed by LV imaging. At least one arterial lesion was present in 123 (66%) on the first study. The most frequently affected arteries were subclavian (42%), axillary (32%), and thoracic aorta (20%). In 106 patients (57%) with serial imaging, new arterial lesions were noted in 41 patients (39%), all of whom had a baseline abnormality, over a mean (±SD) follow-up of 4.39 (2.22) years. New abnormalities were observed in 33% patients by year 2; clinical features of active disease were present at only 50% of these cases. There were no differences in age, sex, temporal artery biopsy positivity, or disease activity in patients with or without new lesions. Conclusions: In this cohort of patients with GCA, LV abnormalities on first imaging were common. Development of new arterial lesions occurred in patients with arterial abnormalities at first imaging, often in the absence of symptoms of active disease. Arterial imaging should be considered in all patients with GCA at diagnosis and serial imaging at least in patients with baseline abnormalities.

AB - Objectives: To evaluate large-vessel (LV) abnormalities on serial imaging in patients with giant cell arteritis (GCA) and discern predictors of new lesions. Methods: Clinical and imaging data from patients with GCA (including subjects diagnosed by LV imaging) enrolled in a prospective, multicenter, longitudinal study and/or a randomized clinical trial were included. New arterial lesions were defined as a lesion in a previously unaffected artery. Results: The study included 187 patients with GCA, 146 (78%) female, mean (±SD) age at diagnosis 68.5 ± 8.5 years; 39% diagnosed by LV imaging. At least one arterial lesion was present in 123 (66%) on the first study. The most frequently affected arteries were subclavian (42%), axillary (32%), and thoracic aorta (20%). In 106 patients (57%) with serial imaging, new arterial lesions were noted in 41 patients (39%), all of whom had a baseline abnormality, over a mean (±SD) follow-up of 4.39 (2.22) years. New abnormalities were observed in 33% patients by year 2; clinical features of active disease were present at only 50% of these cases. There were no differences in age, sex, temporal artery biopsy positivity, or disease activity in patients with or without new lesions. Conclusions: In this cohort of patients with GCA, LV abnormalities on first imaging were common. Development of new arterial lesions occurred in patients with arterial abnormalities at first imaging, often in the absence of symptoms of active disease. Arterial imaging should be considered in all patients with GCA at diagnosis and serial imaging at least in patients with baseline abnormalities.

KW - Aortic aneurysm

KW - Computed tomography angiography

KW - Disease activity

KW - Giant cell arteritis

KW - Large-artery stenosis

KW - Magnetic resonance angiography

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