2015
DOI: 10.3899/jrheum.141347
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Disease Relapses among Patients with Giant Cell Arteritis: A Prospective, Longitudinal Cohort Study

Abstract: Objective To evaluate the frequency, timing, and clinical features of relapses in giant cell arteritis (GCA). Methods Patients with GCA enrolled in a prospective, multicenter, longitudinal study were included in the analysis. Relapse was defined as either new disease activity after a period of remission or worsening disease activity. Results The study included 128 subjects: 102 women (80%) and 26 men (20%). Mean ± SD age at diagnosis of GCA was 69.9 ± 8.6 years. Mean followup for the cohort was 21.4 ± 13.9… Show more

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Cited by 153 publications
(127 citation statements)
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“…Results from other trials with shorter prednisone tapers (12)(13)(14) and longitudinal studies using data from observational cohorts (15)(16)(17) have implied that the failure rate of glucocorticoid therapy for GCA is high. However, GiACTA is the first randomized clinical trial to use a prednisone-tapering regimen in GCA for as long as 1 year, and the first trial in any disease to use a variabledosage prednisone taper in which patients and investigators were blinded with regard to prednisone dosages.…”
Section: Discussionmentioning
confidence: 99%
“…Results from other trials with shorter prednisone tapers (12)(13)(14) and longitudinal studies using data from observational cohorts (15)(16)(17) have implied that the failure rate of glucocorticoid therapy for GCA is high. However, GiACTA is the first randomized clinical trial to use a prednisone-tapering regimen in GCA for as long as 1 year, and the first trial in any disease to use a variabledosage prednisone taper in which patients and investigators were blinded with regard to prednisone dosages.…”
Section: Discussionmentioning
confidence: 99%
“…Despite early treatment with high-dose glucocorticoids, 34-79% relapse. [31][32][33][34] We cannot predict which patients are likely to relapse; identification of relapse is complicated by presentation with non-specific symptoms coupled with normal laboratory tests in up to 20%. 32 It is possible that VEGF may be a useful marker for the identification of relapsing patients, and this should be tested in future studies.…”
Section: Discussionmentioning
confidence: 99%
“…Previous clinical trials have used terms such as “relapses”, “recurrences”, “flares”, or “remission” to define disease activity and often take into consideration markers of inflammation (1119). GCA is a chronic granulomatous vasculitis with observational cohorts reporting at least one disease relapse in 28–64% patients in (2–5, 7, 9, 10). While markers of inflammation such as sedimentation rate and C-reactive protein are neither sensitive nor specific in the assessment of disease activity (8, 26, 27), they are frequently used to assess disease activity in patients with GCA and may influence treatment decisions.…”
Section: Discussionmentioning
confidence: 99%
“…Glucocorticoids remain the mainstay of treatment for patients with GCA but treatment is associated with morbidity in the majority of patients (2). Additionally, relapses are common (210). Several randomized controlled trials have been conducted to evaluate other immunosuppressive therapy in patients with GCA (1119).…”
Section: Introductionmentioning
confidence: 99%