Arterial lesions in giant cell arteritis: A longitudinal study

for the Vasculitis Clinical Research Consortium

Research output: Contribution to journalArticle

11 Scopus citations

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)
Pages (from-to)707-713
Number of pages7
JournalSeminars in Arthritis and Rheumatism
Volume48
Issue number4
DOIs
StatePublished - Feb 2019

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

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