Two-Thirds of Patients With GCA Relapse

Aug 13, 2014

An eight-year study of more than 100 patients with giant cell arteritis reveals that for the majority of patients it is not an isolated episode. Relapses tend to occur within two years, usually as polymyalgia rheumatica or cranial symptoms.

Alba MA, García-Martínez A, Prieto-González S, et al.Relapses in Patients With Giant Cell Arteritis: Prevalence, Characteristics, and Associated Clinical Findings in a Longitudinally Followed Cohort of 106 Patients. Medicine (2014) 93:194–201. doi: 10.1097/MD.0000000000000033

Researchers in Barcelona followed 106 patients with giant cell arteritis (GCA) over eight years to monitor the relapses, the glucortocoid (GC) doses, and GC-related adverse effects.

They defined "relapse" as the reappearance of disease-related symptoms requiring treatment adjustments, and classified them in 4 categories:  polymyalgia rheumatica (PMR); cranial symptoms, including ischemic complications; systemic disease; and symptomatic large vessel involvement.

Other endpoints included cumulative GC dose during the first year, time required to achieve a maintenance prednisone dose <10mg/d (T10), <5mg/d (T5), or complete discontinuation (T0).

Sixty-eight patients (64%) experienced at least one relapse, and 38 (36%) experienced two or more. Patients who relapsed were twice as likely to have osteoporosis (65% vs 32%).

The symptom first relapse was PMR in 51%, cranial symptoms in 31%, and systematic disease in 18%. Relapses occurred predominantly within the first two years. One patient lost vision.

 

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