FRI0312 The frequency and severity of patient-reported symptoms in giant cell arteritis

Abstract

BackgroundA better understanding of the patients' perspectives is pivotal in the development of patient-reported outcomes (PROs) in vasculitis.ObjectivesTo assessed patients' perspective of disease amongst cases with Giant Cell Arteritis (GCA) compared to comparator illnesses mimicking large vessel vasculitis (LVV) included in the Diagnostic and Classification Criteria in Vasculitis Study (DCVAS) database.MethodsPatient Description of Illness (PDI) forms were circulated amongst Centres participating in the DCVAS study. The PDI form records up to 10 free-text severity ranked symptoms in descending order of severity, a body-map to localise the sites of pain and a free-text short summary of illness description. Free text was reorganized through content and thematic analysis.ResultsPDI forms from 89 patients with GCA and 28 comparators (COM) were analysed. There was no difference in age and sex distribution between groups (mean age 70±8 for GCA and 69±12 for COM). The symptoms description and frequency of the first most severe aspect of disease, including the patient's own words, is presented in Table 1. The symptom regarded as the most severe by both groups was headache. While there were no differences in the frequency of sudden visual loss, visual symptoms were reported more commonly as the most severe feature by COM vs GCA (21% vs 8%, p=0.05). Arthralgia was more frequently reported by COM vs GCA (11% vs 1%, p=0.01). Headache was the most frequently reported symptom in both groups. Patients with GCA reported jaw claudication (37%) as the second most frequently reported symptom, while COM reported arthralgia/arthritis (32%). Shoulder/neck pain was the third most important symptom in GCA (33%), while fatigue was the third most common complaint among COM (21%). Fatigue was reported as the fourth most common feature by 30% of GCA patients.Table 1.Top 10 most recurrent patient-reported symptoms and correspondent severity rank in giant cell arteritis (GCA) and Comparators (COM)ItemFrequency in GCASeverity in GCAFrequency in COMSeverity in COMExamples of patient's own words Headache11, 2, 811, 2, 5Headaches; Sore head; Thumping headacheJaw claudication23, 660Jaw ache; Pain in jaw and teethShoulder/neck pain33, 4, 5,00Shoulder upper arm painFatigue45, 6, 1033, 6, 7Severe tiredness; Fatigue; No energy and exhaustedMyalgia or muscle weakness55, 7, 1043Aching muscles; Achey limbs; Loss of strength in arms and legsBlurred vision61054, 8Blurred visionScalp tenderness7804Irritation to the scalp; Tender scalpLoss of appetite800Lack of appetiteFlu-like symptoms9900General ill feeling; Flu-like symptoms; UnwellArthralgia or arthritis10923Hip, knee more on right side; Pain in back of neck, ankles, wrists, and chestOther ENT0074Severe sinusitis; sore inside gumsSudden visual loss008Loss of eyesight to both eyes; Vision lossNight sweats0094, 8Night sweats; Night fever sweatsPainful eyes09100Shooting pain left eye; Pain right eyeConclusionsHeadache was the most frequent and most severe symptom reported by patients with GCA and compara...