Internal Medicine, Hospital Saint-Louis, University Paris Diderot, Paris, France.
Pelyon EA 7425, University Hospital Lyon, Lyon, France.
Rheumatology (Oxford). 2020 Jan 1;59(1):120-128. doi: 10.1093/rheumatology/kez251.
Few data are available on the epidemiology and management of GCA in real life. We aimed to address this situation by using health insurance claims data for France.
This retrospective study used the Echantillon Généraliste de Bénéficiaires (EGB) database, a 1% representative sample of the French national health insurance system. The EGB contains anonymous data on long-term disease status, hospitalizations and reimbursement claims for 752 717 people. Data were collected between 2007 and 2015. The index date was defined as the date of the first occurrence of a GCA code. Demographics, comorbidities, diagnostic tests and therapies were analysed. Annual incidence rates were calculated, and incident and overall GCA cases were studied.
We identified 241 patients with GCA. The annual incidence was 7-10/100 000 people ⩾50 years old. Among the 117 patients with incident GCA, 74.4% were females, with mean age 77.6 years and mean follow-up 2.2 years. After the index date, 51.3% underwent temporal artery biopsy and 29.1% high-resolution Doppler ultrasonography. Among the whole cohort, 84.3% used only glucocorticoids. The most-prescribed glucocorticoid-sparing agent was methotrexate (12.0%).
The incidence of GCA in France is 7-10/100 000 people ⩾ 50 years old. Adjunct agents, mainly methotrexate, are given to only a few patients. The use of temporal artery biopsy in only half of the patients might reflect a shift toward the use of imaging techniques to diagnose GCA.
关于真实世界中巨细胞动脉炎（GCA）的流行病学和治疗，数据有限。我们旨在利用法国的医疗保险索赔数据来解决这一问题。
这项回顾性研究使用了 Echantillon Généraliste de Bénéficiaires（EGB）数据库，该数据库是法国国家健康保险系统的 1%代表性样本，包含 752717 人的长期疾病状态、住院和报销索赔的匿名数据。数据收集于 2007 年至 2015 年期间。索引日期定义为首次出现 GCA 代码的日期。分析了人口统计学、合并症、诊断测试和治疗方法。计算了年发病率，并研究了新发和总体 GCA 病例。
我们确定了 241 例 GCA 患者。50 岁以上人群的年发病率为 7-10/100000 人。在 117 例新发 GCA 患者中，74.4%为女性，平均年龄 77.6 岁，平均随访时间为 2.2 年。在索引日期后，51.3%进行了颞动脉活检，29.1%进行了高分辨率多普勒超声检查。在整个队列中，84.3%仅使用糖皮质激素。最常开的糖皮质激素保留剂是甲氨蝶呤（12.0%）。
法国 GCA 的发病率为 7-10/100000 人 ⩾50 岁。辅助药物，主要是甲氨蝶呤，仅用于少数患者。只有一半的患者进行了颞动脉活检，这可能反映了使用影像学技术诊断 GCA 的趋势。
