Clinical profile and outcome of large-vessel giant cell arteritis in Japanese patients: A single-centre retrospective cohort study

Yamaguchi, Eriho; Kadoba, Keiichiro; Watanabe, Ryu; Iwasaki, Takeshi; Kitagori, Koji; Akizuki, Shuji; Murakami, Kosaku; Nakashima, Ran; Hashimoto, Motomu; Tanaka, Masao; Morinobu, Akio; Yoshifuji, Hajime

doi:10.1093/mr/roac013

Cited by 9 publications

(9 citation statements)

References 29 publications

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“…A retrospective study from Japan found that 18 out of 36 (50%) patients had involvement of non-cranial arteries (33), while another retrospective study from New Zealand found documented involvement of non-cranial arteries in only 10 out of 142 (7%) patients (29).…”

Section: Discussionmentioning

confidence: 98%

“…A major difference between these studies and our study is the study design, with the possibility of missing imaging data for some patients in our study causing a possible underestimation of non-cranial involvement. A retrospective study from Japan found that 18 out of 36 (50%) patients had involvement of non-cranial arteries ( 33 ), while another retrospective study from New Zealand found documented involvement of non-cranial arteries in only 10 out of 142 (7%) patients ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

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Giant cell arteritis: incidence and phenotypic distribution in Western Norway 2013–2020

Skaug,

Fevang,

Assmus

et al. 2023

Front. Med.

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ObjectivesThere is an increasing awareness of the spectrum of phenotypes in giant cell arteritis (GCA). However, there is sparse evidence concerning the phenotypic distribution which may be influenced by both genetic background and the environment. We established a cohort of all GCA-patients in the Bergen Health Area (Western Norway), to describe the phenotypic distribution and whether phenotypes differ with regards to incidence and clinical features.MethodsThis is a retrospective cohort study including all GCA-patients in the Bergen Health Area from 2013–2020. Data were collected by reviewing patient records, and patients considered clinically likely GCA were included if they fulfilled at least one set of classification criteria. Temporal artery biopsy (TAB) and imaging results were used to classify the patients according to phenotype. The phenotype “cranial GCA” was used for patients with a positive TAB or halo sign on temporal artery ultrasound. “Non-cranial GCA” was used for patients with positive findings on FDG-PET/CT, MRI-, or CT angiography, or wall thickening indicative of vasculitis on ultrasound of axillary arteries. Patients with features of both these phenotypes were labeled “mixed.” Patients that could not be classified due to negative or absent examination results were labeled “unclassifiable”.Results257 patients were included. The overall incidence of GCA was 20.7 per 100,000 persons aged 50 years or older. Overall, the cranial phenotype was dominant, although more than half of the patients under 60 years of age had the non-cranial phenotype. The diagnostic delay was twice as long for patients of non-cranial and mixed phenotype compared to those of cranial phenotype. Headache was the most common clinical feature (78% of patients). Characteristic clinic features occurred less frequently in patients of non-cranial phenotype compared to cranial phenotype.ConclusionThe overall incidence for GCA was comparable to earlier reports from this region. The cranial phenotype dominated although the non-cranial phenotype was more common in patients under 60 years of age. The diagnostic delay was longer in patients with the non-cranial versus cranial phenotype, indicating a need for examination of non-cranial arteries when suspecting GCA.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Giant cell arteritis: incidence and phenotypic distribution in Western Norway 2013–2020

Skaug,

Fevang,

Assmus

et al. 2023

Front. Med.

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“…Kermani et al [ 4 ] showed that among patients with GCA, aortic manifestations were associated with increased mortality. On the other hand, Yamaguchi E. et al reported that GCA without LVI has more active disease, more vascular damage, and worse survival than LV-GCA [ 32 ]. Our cohort’s overall survival of Japanese patients with GCA was favorable, and LVI was not associated with relapse or survival.…”

Section: Discussionmentioning

confidence: 99%

“…However, our study showed no significant difference between patients with and without LVI. Recently, another cohort study of Japanese GCA patients reported no difference in age or prevalence of PMR with or without LVI [ 32 ]. Our study was consistent with the previous reports.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features and Outcomes of Japanese Patients with Giant Cell Arteritis: A Comparison with Takayasu Arteritis

Yoshida

Suzuki

Sumichika

et al. 2023

JPM

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Background: Giant cell arteritis (GCA) and Takayasu arteritis (TA) are distinct types of large-vessel vasculitis; however, the clinical features of the diseases have some similarities. Limited data are available regarding Japanese patients with GCA and TA. The present study aimed to compare the clinical features and outcomes of Japanese patients with GCA and TA and the effects of large vessel involvement (LVI). Methods: We performed a retrospective cohort study of the patients with GCA (n = 15) and TA (n = 30) who visited our department from April 2012 to June 2022. Signs and symptoms attributed to the disease, treatment, clinical outcomes, and mortality were recorded using a standardized database. Results: The median age of onset was significantly higher in the GCA group at 24 years (range, 16–72 years) in the TA group and 77 years (range, 57–89 years) in the GCA group (p < 0.001). There were no significant differences in survival rates or the cumulative rates of cardiovascular events between the GCA and TA groups. However, relapse-free survival rates were significantly higher in patients with GCA than in patients with TA. Seven of the 15 patients with GCA had large vessel involvement, which did not affect the survival rates. Prednisolone (PSL) doses were significantly decreased after induction therapy in both groups, and the rates of achieving steroid tapering (PSL < 5.0 mg/day) were significantly higher in patients with GCA compared with those in patients with TA. Conclusions: Our study demonstrated no significant difference in the survival rates of Japanese patients with GCA and TA. The relapse-free survival rates were significantly higher in the GCA group than in the TA group. LVI may not be associated with disease relapse or survival rate in Japanese patients with GCA.

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“…Large vessel involvement can be complicated by aortic dissection and aneurysm formation, while inflammation of medium-sized arteries causes headache, jaw claudication, loss of vision, and stroke. Moreover, extravascular manifestations —such as fever, malaise, weight loss, polymyalgia rheumatica—also frequently occur ( Buttgereit et al, 2016 ; Yamaguchi et al, 2022 ). The currently available treatments for GCA include glucocorticoids and tocilizumab (TCZ), an IL-6 receptor inhibitor.…”

Section: Introductionmentioning

confidence: 99%

Aging-Related Vascular Inflammation: Giant Cell Arteritis and Neurological Disorders

Watanabe¹,

Hashimoto²

2022

Front. Aging Neurosci.

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Aging is characterized by the functional decline of the immune system and constitutes the primary risk factor for infectious diseases, cardiovascular disorders, cancer, and neurodegenerative disorders. Blood vessels are immune-privileged sites and consist of endothelial cells, vascular smooth muscle cells, macrophages, dendritic cells, fibroblasts, and pericytes, among others. Aging also termed senescence inevitably affects blood vessels, making them vulnerable to inflammation. Atherosclerosis causes low-grade inflammation from the endothelial side; whereas giant cell arteritis (GCA) causes intense inflammation from the adventitial side. GCA is the most common autoimmune vasculitis in the elderly characterized by the formation of granulomas composed of T cells and macrophages in medium- and large-sized vessels. Recent studies explored the pathophysiology of GCA at unprecedented resolutions, and shed new light on cellular signaling pathways and metabolic fitness in wall-destructive T cells and macrophages. Moreover, recent reports have revealed that not only can cerebrovascular disorders, such as stroke and ischemic optic neuropathy, be initial or coexistent manifestations of GCA, but the same is true for dementia and neurodegenerative disorders. In this review, we first outline how aging affects vascular homeostasis. Subsequently, we review the updated pathophysiology of GCA and explain the similarities and differences between vascular aging and GCA. Then, we introduce the possible link between T cell aging, neurological aging, and GCA. Finally, we discuss therapeutic strategies targeting both senescence and vascular inflammation.

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Clinical profile and outcome of large-vessel giant cell arteritis in Japanese patients: A single-centre retrospective cohort study

Cited by 9 publications

References 29 publications

Giant cell arteritis: incidence and phenotypic distribution in Western Norway 2013–2020

Giant cell arteritis: incidence and phenotypic distribution in Western Norway 2013–2020

Clinical Features and Outcomes of Japanese Patients with Giant Cell Arteritis: A Comparison with Takayasu Arteritis

Aging-Related Vascular Inflammation: Giant Cell Arteritis and Neurological Disorders

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