Background/Purpose: Aortitis and periaortitis include a heterogeneous group of entities that may be idiopathic or secondary to infectious and non-infectious processes. Therefore, treatment will differ considerably depending on the underlying cause.  Our aim was to assess therapy and the response in a wide series of patients with aortitis or periaortitis from a single university center.

Methods: Observational study of patients with aortitis or periaortitis from a referral center in Spain. Outcomes were: clinical remission (absence of clinical symptoms), complete remission (absence of clinical symptoms and analytical normalization), and absence of systemic inflammation (complete remission and imaging remission) . Safety was also evaluated.

Results: We included 134 patients (87 female/47 male) (mean age: 55.1±9.1 years) with aortitis (n=132) or periaortitis (n=2) related to different diseases. They were treated with glucocorticosteroids (n=127; 94.8%), immunosuppressive synthetic drugs (68; 50.7%), biologic therapy (n= 48; 35.8%), antibiotics (n=3; 1.5%) and surgery (n=6; 4,5%) (Table 1). Adverse effects registered were: abdominal pain (n=6, 4.5%), vomit (n=3, 2.2%), anxiety (n=3, 2.2%), diarrhoea (n=2 , 1.5%) , tremor (n=1, 0.7%), increase appetite (n=1, 0.7%) , pyrosis (n=1, 0.7%), asthenia (n=1, 0.7%) and dyspnoea (n=1, 0.7%) . After a follow-up of 39.2±26.7 months, 19 patients (14.2%) experimented clinical remission, 64 (47.8%) complete remission and 16 (11.9%) absence of systemic inflammation (Figure 1). At the diagnosis, ¹⁸F-FDG PET/CT scan was positive in all patients, during the follow up ¹⁸F-FDG PET/CT scan was performed in 87 patients (65%) . The mean time between baseline and follow up ¹⁸F-FDG PET/CT scans was 18.1±15.1 months, observing the following changes in ¹⁸F-FDG uptake: absent (n= 20, 23%), decrease (n=32, 36.8%), similar uptake (n= 22, 25.3%) and increase (n= 13 , 14.9%) (Figure 2).

Conclusion: Aortitis and periaortitis are entities that require an early treatment. Corticosteroids are the first line of treatment in patients with non-infectious aortitis or periaortitis.  ¹⁸F-FDG PET/CT scan is a useful imaging technique to evaluate the activity and response to different treatments.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/treatment-and-evolution-in-134-patients-with-aortitis-and-periaortitis-experience-of-a-single-referral-centre/