Predictors of relapse and treatment outcomes in biopsy-proven giant cell arteritis: A retrospective cohort study

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Abstract

Objective. To evaluate characteristics of relapse, relapse rates, treatment and outcomes among patients with biopsy-proven GCA in a large, single-institution cohort. Methods. We conducted a retrospective review of all patients with biopsy-proven GCA from 1998 to 2013. Demographic, clinical, laboratory and treatment data at presentation and during follow-up were collected. Comparisons by relapse rate were performed using chi-square tests. Prednisone discontinuation by initial oral dose ≤40 and >40 mg/day was compared using Cox models. Results. The cohort included 286 patients [74% female, mean age at diagnosis 75.0 years (S.D. 7.6), median follow-up 5.1 years). During follow-up, 73 patients did not relapse, 80 patients had one relapse and 133 had two or more relapses. The first relapse occurred during the first year in 50% of patients, by 2 years in 68% and by 5 years in 79%. More patients with established hypertension (P = 0.007) and diabetes (P = 0.039) at GCA diagnosis were in the high relapse rate group (≥0.5 relapses/year) and more females were in the low or high relapse groups than in the no relapse group (P = 0.034). Patients receiving an initial oral prednisone dose>40 mg/day were able to reach a dose of40 mg/day achieved earlier prednisone discontinuation.

Original languageEnglish (US)
Pages (from-to)347-356
Number of pages10
JournalRheumatology (United Kingdom)
Volume55
Issue number2
DOIs
StatePublished - Oct 5 2015

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Giant Cell Arteritis
Cohort Studies
Retrospective Studies
Biopsy
Recurrence
Prednisone
Chi-Square Distribution
Proportional Hazards Models
Demography
Hypertension

Keywords

  • Adverse events
  • Cohort
  • Diabetes
  • Giant cell arteritis
  • Glucocorticoids
  • Hypertension
  • Relapse
  • Retrospective

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

Cite this

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title = "Predictors of relapse and treatment outcomes in biopsy-proven giant cell arteritis: A retrospective cohort study",
abstract = "Objective. To evaluate characteristics of relapse, relapse rates, treatment and outcomes among patients with biopsy-proven GCA in a large, single-institution cohort. Methods. We conducted a retrospective review of all patients with biopsy-proven GCA from 1998 to 2013. Demographic, clinical, laboratory and treatment data at presentation and during follow-up were collected. Comparisons by relapse rate were performed using chi-square tests. Prednisone discontinuation by initial oral dose ≤40 and >40 mg/day was compared using Cox models. Results. The cohort included 286 patients [74{\%} female, mean age at diagnosis 75.0 years (S.D. 7.6), median follow-up 5.1 years). During follow-up, 73 patients did not relapse, 80 patients had one relapse and 133 had two or more relapses. The first relapse occurred during the first year in 50{\%} of patients, by 2 years in 68{\%} and by 5 years in 79{\%}. More patients with established hypertension (P = 0.007) and diabetes (P = 0.039) at GCA diagnosis were in the high relapse rate group (≥0.5 relapses/year) and more females were in the low or high relapse groups than in the no relapse group (P = 0.034). Patients receiving an initial oral prednisone dose>40 mg/day were able to reach a dose of40 mg/day achieved earlier prednisone discontinuation.",
keywords = "Adverse events, Cohort, Diabetes, Giant cell arteritis, Glucocorticoids, Hypertension, Relapse, Retrospective",
author = "Cristian Labarca and Matthew Koster and Cynthia Crowson and Ashima Makol and Ytterberg, {Steven R} and Matteson, {Eric Lawrence} and Warrington, {Kenneth J}",
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T1 - Predictors of relapse and treatment outcomes in biopsy-proven giant cell arteritis

T2 - A retrospective cohort study

AU - Labarca, Cristian

AU - Koster, Matthew

AU - Crowson, Cynthia

AU - Makol, Ashima

AU - Ytterberg, Steven R

AU - Matteson, Eric Lawrence

AU - Warrington, Kenneth J

PY - 2015/10/5

Y1 - 2015/10/5

N2 - Objective. To evaluate characteristics of relapse, relapse rates, treatment and outcomes among patients with biopsy-proven GCA in a large, single-institution cohort. Methods. We conducted a retrospective review of all patients with biopsy-proven GCA from 1998 to 2013. Demographic, clinical, laboratory and treatment data at presentation and during follow-up were collected. Comparisons by relapse rate were performed using chi-square tests. Prednisone discontinuation by initial oral dose ≤40 and >40 mg/day was compared using Cox models. Results. The cohort included 286 patients [74% female, mean age at diagnosis 75.0 years (S.D. 7.6), median follow-up 5.1 years). During follow-up, 73 patients did not relapse, 80 patients had one relapse and 133 had two or more relapses. The first relapse occurred during the first year in 50% of patients, by 2 years in 68% and by 5 years in 79%. More patients with established hypertension (P = 0.007) and diabetes (P = 0.039) at GCA diagnosis were in the high relapse rate group (≥0.5 relapses/year) and more females were in the low or high relapse groups than in the no relapse group (P = 0.034). Patients receiving an initial oral prednisone dose>40 mg/day were able to reach a dose of40 mg/day achieved earlier prednisone discontinuation.

AB - Objective. To evaluate characteristics of relapse, relapse rates, treatment and outcomes among patients with biopsy-proven GCA in a large, single-institution cohort. Methods. We conducted a retrospective review of all patients with biopsy-proven GCA from 1998 to 2013. Demographic, clinical, laboratory and treatment data at presentation and during follow-up were collected. Comparisons by relapse rate were performed using chi-square tests. Prednisone discontinuation by initial oral dose ≤40 and >40 mg/day was compared using Cox models. Results. The cohort included 286 patients [74% female, mean age at diagnosis 75.0 years (S.D. 7.6), median follow-up 5.1 years). During follow-up, 73 patients did not relapse, 80 patients had one relapse and 133 had two or more relapses. The first relapse occurred during the first year in 50% of patients, by 2 years in 68% and by 5 years in 79%. More patients with established hypertension (P = 0.007) and diabetes (P = 0.039) at GCA diagnosis were in the high relapse rate group (≥0.5 relapses/year) and more females were in the low or high relapse groups than in the no relapse group (P = 0.034). Patients receiving an initial oral prednisone dose>40 mg/day were able to reach a dose of40 mg/day achieved earlier prednisone discontinuation.

KW - Adverse events

KW - Cohort

KW - Diabetes

KW - Giant cell arteritis

KW - Glucocorticoids

KW - Hypertension

KW - Relapse

KW - Retrospective

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