TY - JOUR
T1 - Evaluation of damage in giant cell arteritis
AU - for the Vasculitis Clinical Research Consortium
AU - Kermani, Tanaz A.
AU - Sreih, Antoine G.
AU - Cuthbertson, David
AU - Carette, Simon
AU - Hoffman, Gary S.
AU - Khalidi, Nader A.
AU - Koening, Curry L.
AU - Langford, Carol A.
AU - McAlear, Carol A.
AU - Monach, Paul A.
AU - Moreland, Larry
AU - Pagnoux, Christian
AU - Seo, Philip
AU - Warrington, Kenneth J.
AU - Ytterberg, Steven R.
AU - Merkel, Peter A.
N1 - Publisher Copyright:
© The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Objectives. To evaluate damage and variables associated with damage in GCA. Methods. Patients with GCA enrolled in a prospective, multicentre, longitudinal study were included. Perprotocol assessments were made with the Vasculitis Damage Index and the Large-Vessel Vasculitis Index of Damage. Results. The study included 204 patients: 156 women (76%), mean age at diagnosis 71.3 years (S.D. 8.3), mean follow-up of 3.5 years (S.D. 1.9). One or more damage item was present in 54% at baseline and 79% at the last follow-up on the Vasculitis Damage Index, and 60% at baseline and 82% at the last follow-up on the Large-Vessel Vasculitis Index of Damage. The most frequently observed damage items were largeartery complications (29% cohort) and ocular (22%). Among 117 patients with new damage, most new items were ocular (63 patients), cardiac/vascular (48) and musculoskeletal (34). Of these, treatment-associated items were frequently observed, including cataracts (46 patients), osteoporosis (22) and weight gain (22). Disease-associated new damage included ischaemic optic neuropathy (3 patients), limb claudication (13), arterial occlusions (10) and damage requiring vascular intervention (10). In univariate analysis, the risk of damage increased 22% for every additional year of disease duration [odds ratio (OR) 1.22 (95% CI 1.04, 1.45)]. In 94 patients enrolled within ≤90 days of diagnosis of GCA, the risk of new damage at the last follow-up decreased 30% for each additional relapse [OR 0.70 (95% CI 0.51, 0.97)]. Conclusions. Large-artery complications and ocular manifestations are the most commonly occurring items of damage in GCA. Most new damage is associated with treatment. These findings emphasize the cumulative burden of disease in GCA.
AB - Objectives. To evaluate damage and variables associated with damage in GCA. Methods. Patients with GCA enrolled in a prospective, multicentre, longitudinal study were included. Perprotocol assessments were made with the Vasculitis Damage Index and the Large-Vessel Vasculitis Index of Damage. Results. The study included 204 patients: 156 women (76%), mean age at diagnosis 71.3 years (S.D. 8.3), mean follow-up of 3.5 years (S.D. 1.9). One or more damage item was present in 54% at baseline and 79% at the last follow-up on the Vasculitis Damage Index, and 60% at baseline and 82% at the last follow-up on the Large-Vessel Vasculitis Index of Damage. The most frequently observed damage items were largeartery complications (29% cohort) and ocular (22%). Among 117 patients with new damage, most new items were ocular (63 patients), cardiac/vascular (48) and musculoskeletal (34). Of these, treatment-associated items were frequently observed, including cataracts (46 patients), osteoporosis (22) and weight gain (22). Disease-associated new damage included ischaemic optic neuropathy (3 patients), limb claudication (13), arterial occlusions (10) and damage requiring vascular intervention (10). In univariate analysis, the risk of damage increased 22% for every additional year of disease duration [odds ratio (OR) 1.22 (95% CI 1.04, 1.45)]. In 94 patients enrolled within ≤90 days of diagnosis of GCA, the risk of new damage at the last follow-up decreased 30% for each additional relapse [OR 0.70 (95% CI 0.51, 0.97)]. Conclusions. Large-artery complications and ocular manifestations are the most commonly occurring items of damage in GCA. Most new damage is associated with treatment. These findings emphasize the cumulative burden of disease in GCA.
KW - Damage
KW - Giant cell arteritis
KW - Large-artery manifestations
KW - Large-vessel vasculitis
KW - Vasculitis
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U2 - 10.1093/rheumatology/kex397
DO - 10.1093/rheumatology/kex397
M3 - Article
C2 - 29112740
AN - SCOPUS:85041520199
SN - 1462-0324
VL - 57
SP - 322
EP - 328
JO - Rheumatology (United Kingdom)
JF - Rheumatology (United Kingdom)
IS - 2
M1 - kex397
ER -