Corticosteroid Therapy in Giant Cell Arteritis, Predictors for Long-Term Remission

Luigi Boiardi¹, Giovanna Restuccia², Pierluigi Macchioni¹, Francesco Muratore¹, Alberto Cavazza³, Luca Cimino⁴, Raffaella Aldigeri⁵, Mariagazia Catanoso⁶, Nicolò Pipitone⁶ and Carlo Salvarani⁷, ¹Rheumatology Service, Arcispedale S Maria Nuova, IRCCS, Reggio Emilia, Italy, ²Rheumatology Service, Arcispedale S Maria Nuova-IRCCS, 42100, Italy, ³Pathology Unit, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy, ⁴Ophthalmology Unit, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy, ⁵Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy, ⁶Rheumatology Service, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy, ⁷Rheumatology Unit, Internal Medicine Department, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Corticosteroids and giant cell arteritis

Session Information

Date: Monday, November 9, 2015

Title: Vasculitis Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose:

The aim of our study was to determine the frequency and the predictors of long-lasting remission in a cohort of consecutive patients with biopsy-proven GCA.

Methods:

We recruited all patients with a diagnosis of biopsy-proven GCA performed at our Center between 1986 through 2007. Only patients with a follow-up period longer than 6 months were included in the study. A pathologist with expertise in vasculitis reviewed all temporal artery biopsies (TABs). Demographic, clinical and laboratory data at presentation and at each follow-up visit were retrospectively collected. Long-lasting remission was recorded as the date of permanent discontinuation of treatment without recurrence of symptoms and elevation of inflammatory markers for at least 1 year.Logistic regression was used to calculate the predictors for long-lasting remission.

Results:

182 patients had a diagnosis of biopsy-proven GCA in the study period. 156 patients had a follow-up of at least 6 months and represented our study population. The median of follow-up period for the 156 patients included was 80 (range 49-125) months. The median initial dosage of prednisone was 50 mg/day. The median duration required to achieve a maintenance dose of prednisone less than 5 mg/day was 8.5 months (range 7.0-12.0). The median duration required to achieve a permanent steroid discontinuation was 21 months (range 12.5-36) in our cohort. 58 patients (37%) were able to discontinue treatment at least 1 year before the end of follow-up without ever having flares. At the time of the last follow-up visit 72 patients (46%) were still taking glucocorticoids. Predictive variables for long-lasting remission were age less 70 years (0.030) and male gender (p=0.030).

Conclusion:

37% of patients of our cohort were able to remain in persistent treatment-free remission (no flare during the entire follow-up period). Predictive variables for long lasting remission were age less 70 years and male gender.

Disclosure: L. Boiardi, None; G. Restuccia, None; P. Macchioni, None; F. Muratore, None; A. Cavazza, None; L. Cimino, None; R. Aldigeri, None; M. Catanoso, None; N. Pipitone, None; C. Salvarani, None.

To cite this abstract in AMA style:

Boiardi L, Restuccia G, Macchioni P, Muratore F, Cavazza A, Cimino L, Aldigeri R, Catanoso M, Pipitone N, Salvarani C. Corticosteroid Therapy in Giant Cell Arteritis, Predictors for Long-Term Remission [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/corticosteroid-therapy-in-giant-cell-arteritis-predictors-for-long-term-remission/. Accessed .

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