Large-vessel involvement and aortic dilation in giant-cell arteritis. A multicenter study of 549 patients

Boysson, Hubert de; Daumas, Aurélie; Vautier, Mathieu; Parienti, Jean‐Jacques; Liozon, É.; Lambert, Marc; Samson, Maxime; Ebbo, Mikaël; Dumont, Anaël; Sultan, Audrey; Bonnotte, Bernard; Manrique, Alain; Bienvenu, Boris; Saadoun, David; Aouba, Achille

doi:10.1016/j.autrev.2017.11.029

Cited by 118 publications

(102 citation statements)

References 33 publications

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“…These data suggest that GCA patients with LVLs, especially aortic lesions, may be resistant to initial conventional immunosuppressive therapy without biologics. The present study showed that the mean age at diagnosis, male to female ratio, frequency of cranial signs and symptoms, and PMR were almost the same as epidemiological findings in Western countries [7,13,[19][20][21]. Prevalence and distribution of LVLs were various among previous cohorts [4,19,20,[22][23][24][25] by different inclusion criteria and imaging modalities used for the diagnosis.…”

Section: Discussionsupporting

confidence: 81%

“…Treatment responses of GCA with LVLs are controversial among observational studies [20,21,[35][36][37][38]. The present study showed only the presence of LVLs at baseline was an associated factor of non-achievement of clinical remission or relapse, while initial PSL dose, PSL tapering speed during the initial 12 weeks, and immunosuppressive drug use at baseline were not.…”

Section: Discussionmentioning

confidence: 46%

“…20 Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan. 21 Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan. 22 Department of Vascular Physiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan.…”

Section: Acknowledgementsmentioning

confidence: 99%

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Associated factors of poor treatment outcomes in patients with giant cell arteritis: clinical implication of large vessel lesions

et al. 2020

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Background: Relapses frequently occur in giant cell arteritis (GCA), and long-term glucocorticoid therapy is required. The identification of associated factors with poor treatment outcomes is important to decide the treatment algorithm of GCA. Methods: We enrolled 139 newly diagnosed GCA patients treated with glucocorticoids between 2007 and 2014 in a retrospective, multi-center registry. Patients were diagnosed with temporal artery biopsy, 1990 American College of Rheumatology classification criteria, or large vessel lesions (LVLs) detected by imaging based on the modified classification criteria. Poor treatment outcomes (non-achievement of clinical remission by week 24 or relapse during 52 weeks) were evaluated. Clinical remission was defined as the absence of clinical signs and symptoms in cranial and large vessel areas, polymyalgia rheumatica (PMR), and elevation of C-reactive protein (CRP) levels. A patient was determined to have a relapse if he/she had either one of the signs and symptoms that newly appeared or worsened after achieving clinical remission. Re-elevation of CRP without clinical manifestations was considered as a relapse if other causes such as infection were excluded and the treatment was intensified. Associated factors with poor treatment outcomes were analyzed by using the Cox proportional hazard model.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 46%

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Associated factors of poor treatment outcomes in patients with giant cell arteritis: clinical implication of large vessel lesions

et al. 2020

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“…Die frühzeitige Detektion einer Aortitis ist relevant, da das Risiko einer Aortendilatation im weiteren Verlauf der Erkrankung bei initialem Aortenbefall mit einem Hazard Ratio von 3,16 in einer großen aktuellen Studie erhöht war [10].…”

Section: Diagnostikunclassified

Aktuelle Empfehlungen zur Diagnostik der Riesenzellarteriitis

Bley¹,

Zänker²,

Dechant³

et al. 2019

Dtsch med Wochenschr

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In Giant Cell Arteritis (GCA), a timely diagnosis is required to avoid severe complications such as blindness or structural vascular damage. The heterogeneous symptoms are mainly due to local and systemic inflammatory processes. Diagnostics are based on increased inflammation parameters in the laboratory, imaging, in which color-coded duplex sonography (FKDS), high-resolution magnetic resonance imaging (MRI), computer tomography (CT) or CT angiography (CTA) and 18F fluorodeoxyglucose-positron emission tomography with CT (FDG-PET-CT) have become established, as well as histopathological findings in temporal artery biopsy.

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“…Viele Rheumatologen sind dazu übergegangen, die RZA in eine kraniale RZA, mit klassischem Befallsmuster wie oben geschildert, und in eine extrakraniale RZA zu unterteilen, wobei Letztere die wirklich großkalibrigen Gefäße, wie die Aorta, bevorzugt befällt. Gerade ältere Patienten (> 80 Jahre) zeigen häufiger das klassische kraniale Befallsmuster, während der Anteil an einer primär extrakranialen RZA bei unter 70-jährigen Patienten höher ist [7].…”

Section: Update Zur Bildgebenden Diagnostik Bei Patienten Mit Großgefunclassified

Update zur bildgebenden Diagnostik bei Patienten mit Großgefäßvaskulitis

Klink¹,

Bley²

2019

Radiologie up2date

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Large-vessel involvement and aortic dilation in giant-cell arteritis. A multicenter study of 549 patients

Cited by 118 publications

References 33 publications

Associated factors of poor treatment outcomes in patients with giant cell arteritis: clinical implication of large vessel lesions

Associated factors of poor treatment outcomes in patients with giant cell arteritis: clinical implication of large vessel lesions

Aktuelle Empfehlungen zur Diagnostik der Riesenzellarteriitis

Update zur bildgebenden Diagnostik bei Patienten mit Großgefäßvaskulitis

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