Quality of life of patients treated for giant cell arteritis: a case-control study

Abstract

The objective of the study was to assess the quality of life (QOL) of patients with giant cell arteritis (GCA), following high dose of corticosteroids (CS). Thirty patients with GCA who had stopped CS or who were under long-term low dose of CS were included and matched to 60 controls. QOL was measured by the SF-36 score and a specific questionnaire. GCA patients had no impairment of QOL compared to controls according to SF-36. Most of them (57%) estimated that their general condition was improved following treatment. Patients with GCA complications or CS therapy side effects had no significant impairment of their QOL compared with patients without complications or adverse effects. Only the patients who had gained weight had a lower score on the domain "Vitality" (VT; p = 0.013). Walking difficulties were the most frequent complaints. They were associated with impaired scores on the physical summary score (p = 0.0340) and on the "General Health" (GH; p = 0.005) and "Physical Functioning" (PF, p = 0.0298) domains. Falls among GCA patients were associated with altered scores on the domain VT (p = 0.0058) and on the mental summary score if they had fallen at least three times (p = 0.0460). GCA patients following high dose of CS or under long-term low doses of CS have no significant impairment of their QOL compared to controls. GCA complications, including visual impairment, do not seem to have any major impact on QOL.

Characteristics of patients with giant cell arteritis who experience visual symptoms

“…Though a qualitative study performed in the UK also found that anxiety about future visual loss was an important concern of GCA patients [23], this is in contrast to other studies. Jobard et al and Kupersmith et al found that GCA visual complications did not have any major impact on health-related quality of life (QoL), as assessed using the SF-36 score [24,25]. However, neither of the aforementioned studies distinguished between patients with and without visual symptoms.…”

“…As we appreciate that vision ranks as the number one concern among patients with GCA [24], our study used the VF-14 [26] as a measure of visual function among GCA subjects. Expectedly, GCA patients with current visual symptoms had lower (worse) VF-14 score than those without visual symptoms.…”

S2k-Leitlinie: Management der Großgefäßvaskulitiden

“…Die Lebensqualität wird aus Sicht der Betroffenen durch die Angst vor Visusverlust und anderen ischämischen Komplikationen sowie vor Nebenwirkungen der GC-Therapie bestimmt. Sie gleicht sich gesunden Kontrollen an, wenn eine anhaltende Remission unter niedrig dosierten oder ausgeschlichenen GC erreicht werden kann [124].…”

Health-related quality of life in patients with giant cell arteritis treated with tocilizumab in a phase 3 randomised controlled trial

“…Fears surrounding potential vision loss and dissatisfaction with the adverse effects of glucocorticoids were identified as the most important HRQOL concerns in a survey of patients with GCA [11], but vision loss was not associated with impaired HRQOL at baseline or after treatment with glucocorticoids with or without methotrexate in an RCT that enrolled too few patients for a treatment effect to be investigated [12]. In a case-control study, HRQOL was not impaired in patients with GCA either before or after glucocorticoid treatment compared with controls [13], though this study examined only HRQOL data after high-dose glucocorticoid treatment had been discontinued (the 30 patients in the analysis had either stopped corticosteroid treatment or were taking long-term low doses of glucocorticoids).…”