A Real-World Study from the Greater Paris Clinical Data Warehouse

Aïcha Kante¹, Olivier Hassanaly², Geoffroy Peyrac³, David Saadoun⁴, Cacoub Patrice⁴, Alexis REGENT⁵, Benjamin Terrier⁶, Luc Mouthon⁷, Arsène Mekinian⁸, Karim Sacré⁹, Jean-François Alexandra¹⁰, Sébastien Abad¹¹, Robin Dhote¹¹, Cécile goujard¹², Damien Sène¹³, Stéphane Mouly¹⁴, Baptiste Hervier¹⁵, Olivier Bory¹⁶, Elisabeth Aslangul¹⁶, Isabelle Mahé¹⁶, Anne Couvelard¹⁷, Yann Nguyen¹⁸, Agnès Lefort¹⁸, Sophie georgin-Lavialle¹⁹, Olivier Steichen¹⁹, Viet-Thi Tran²⁰ and Cloé Comarmond¹, ¹Department of Internal Medicine, Lariboisière University Hospital, Université Paris Cité, Assistance Publique Hôpitaux de Paris, INSERM U⁹⁴², Paris, France, ²Unité de recherche clinique, AP-HP, Hôpital Saint Louis, F⁷⁵⁰¹⁰, Paris, France, Paris, France, ³Department of Internal Medicine, Lariboisière University Hospital, Université Paris Cité, AP-HP, Paris, France, ⁴Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre national de références Maladies Autoimmunes et systémiques rares, Centre national de références Maladies Autoinflammatoires rares et Amylose inflammatoire (CEREMAIA), INSERM, UMR S⁹⁵⁹, Immunology-Immunopathology-Immunotherapy (I³), Paris, France, Paris, France, ⁵Hopital Cochin, Paris, France, ⁶Cochin Hospital, Paris, France, ⁷Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Cochin University Hospital, Université Paris Cité, AP-HP, Paris, France, ⁸Department of Internal Medicine, Inflammation-Immunopathology-Biotherapy Department (DMU i³), Saint-Antoine University Hospital, ⁷⁵⁰¹² Paris, France, Paris, France, ⁹Department of Internal Medicine, Bichat University Hospital, Université Paris Cité, AP-HP, Paris, France, Paris, France, ¹⁰Internal Medicine, Hôpital Bichat, APHP, Paris, France, ¹¹Service de Médecine Interne, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP); Université Paris ¹³, Sorbonne Paris Cité, Bobigny, France, Bobigny, France, ¹²Université Paris Saclay, Department of Internal Medicine and Clinical Immunology, Bicêtre Hospital, APHP, UMR¹¹⁸⁴ Inserm, CEA, Le Kremlin Bicêtre, France, Kremlin Bicêtre, France, ¹³Department of Internal Medicine, Lariboisière University Hospital, Université Paris Cité, Assistance Publique Hôpitaux de Paris, Paris, Ile-de-France, France, ¹⁴Department of Internal Medicine, Lariboisière University Hospital, Université Paris Cité, Assistance Publique Hôpitaux de Paris, Paris, France, ¹⁵Internal Medicine Department, Hôpital Saint-Louis, AP-HP, Université Paris Cité, Paris, France., Paris, France, ¹⁶Department of Internal Medicine, Louis-Mourier Hospital, AP-HP, Colombes, France, Colombes, France, ¹⁷Pathology Department, Bichat and Beaujon Hospitals, AP-HP, FHU MOSAIC, Université Paris Cité, Paris, France, Paris, France, ¹⁸Department of Internal Medicine, Beaujon Hospital, AP-HP Nord, Université Paris Cité, Clichy, France, Clichy, France, ¹⁹Sorbonne university, Tenon hospital, DMU³ID, CEREMAIA, ERN RITA, Paris, France, ²⁰Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAe, Centre for Research in Epidemiology and Statistics (CRESS), Paris; and Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, AP-HP, Paris, France, Paris, France

Meeting: ACR Convergence 2025

Keywords: corticosteroids, Epidemiology, giant cell arteritis, prognostic factors, registry

Session Information

Date: Sunday, October 26, 2025

Title: (0731–0764) Vasculitis – Non-ANCA-Associated & Related Disorders Poster I

Session Type: Poster Session A

Session Time: 10:30AM-12:30PM

Background/Purpose: Giant cell arteritis (GCA) relapses are frequent and often require therapeutic intensification in the form of glucocorticoids (GC) increase. GCA management has significantly evolved following the publication of the GiACTA trial and the subsequent approval of tocilizumab (TCZ) in 2017, allowing for faster GC tapering without relapse. In this study, we aimed to describe real-world diagnostic practices, management strategies and mortality outcome in patients with new-onset GCA from 2017 to 2024.

Methods: All patients diagnosed GCA between August 1st 2017 and May 30th 2024, were identified in the Clinical Data Warehouse of Assistance Publique–Hôpitaux de Paris using the French Medical Information System Program coding system. Stored data integrates clinical, biological and imaging data from patients hospitalized across all public hospitals in the Greater Paris area. To improve cohort accuracy, a natural language processing algorithm was applied to detect and exclude miscoded entries. Patients without a recorded prescription for GC were excluded. The study flowchart is presented in Figure 1. The risk of death was assessed using a multivariate Cox proportional hazards model.

Results: A total of 843 patients were included in the study, 543 (64%) of whom were female, with a median [interquartile range] age at diagnosis of 74 [68–81] years, and median follow-up 6.4 [3.0-9.9] years (Table 1). The use of positron emission tomography increased from 30.4% of patients in the year 2017, to 36.5% in the year 2024. Conversely, the proportion of temporal artery biopsies declined from 47.8% in 2017, compared to 38.5% in the year 2024. At diagnosis, 772 (91.6%) received GC monotherapy while 71 (8.4%) received combined therapy with TCZ and GC. During follow-up, 400 (47.5%) GCA patients required GC intensification, including 319 (38%) at 1 year, 363 (43%) at 2 years and 380 (45%) at 3 years. The median time to first GC intensification was 1.4 [0.1–5.6] years. The median GC dose before intensification was 10 [5-20] mg/day which increased to 35 [20-50] mg/day following intensification. Overall, 91 (11%) patients died during follow-up. In a multivariate analysis (Table 2), older age at diagnosis (p< 0.01) and the presence of a stroke at baseline (p< 0.01) were independently associated with an increased risk of mortality.

Conclusion: In this contemporary French cohort, nearly half of patients with GCA required at least one GC intensification during the course of treatment. Stroke at baseline and older age at diagnosis were identified as independent risk factors for all-cause mortality.

Figure 1. Study flowchart

Abbreviations: GCA: giant cell arteritis; GC: glucocorticoids; PMR: polymyalgia rheumatica.

Table 1. Clinical characteristics at GCA diagnosis.

Abbreviations: GCA: giant cell arteritis; CT: computed tomography; PET : positron emission tomography

* Comorbidities at baseline were defined as clinical history or concomitant to GCA diagnosis.

Table 2. Survival analysis for risk of death among GCA patients.

Results of both univariate and multivariate survival analysis for the risk of death following GCA diagnosis, using a Cox proportional hazard model. Comorbidities at baseline were defined as clinical history or concomitant to GCA diagnosis.

Abbreviations: CI: confidence interval; GCA: giant cell arteritis; HR: hazard ratio

Disclosures: A. Kante: None; O. Hassanaly: None; G. Peyrac: None; D. Saadoun: None; C. Patrice: None; A. REGENT: Novartis, 2; B. Terrier: Amgen, 1, AstraZeneca, 1, 2, GlaxoSmithKlein(GSK), 1, 2, Novartis, 1, 2, Roche, 5, Vifor Pharma, 2; L. Mouthon: None; A. Mekinian: Roche, 5; K. Sacré: None; J. Alexandra: Chugai France, 2; S. Abad: None; R. Dhote: None; C. goujard: None; D. Sène: None; S. Mouly: None; B. Hervier: None; O. Bory: None; E. Aslangul: None; I. Mahé: None; A. Couvelard: None; Y. Nguyen: None; A. Lefort: None; S. georgin-Lavialle: Novartis, 2, Sobi, 2; O. Steichen: None; V. Tran: None; C. Comarmond: Roche, 5.

To cite this abstract in AMA style:

Kante A, Hassanaly O, Peyrac G, Saadoun D, Patrice C, REGENT A, Terrier B, Mouthon L, Mekinian A, Sacré K, Alexandra J, Abad S, Dhote R, goujard C, Sène D, Mouly S, Hervier B, Bory O, Aslangul E, Mahé I, Couvelard A, Nguyen Y, Lefort A, georgin-Lavialle S, Steichen O, Tran V, Comarmond C. A Real-World Study from the Greater Paris Clinical Data Warehouse [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/a-real-world-study-from-the-greater-paris-clinical-data-warehouse/. Accessed .

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