Perrineau Ségolène, Ghesquière Thibault, Charles Pierre, Paule Romain, Samson Maxime, Gayraud Martine, Chauvin Anthony, Terrier Benjamin, Guillevin Loic, Bonnotte Bernard, Mouthon Luc, Régent Alexis
Department of Internal Medicine, Hôpital Cochin, Université de Paris, Sorbonne Paris Cité, INSERM Unité 1016, Centre de Référence pour les Maladies Auto-immunes Rares, Paris, France.
Department of Internal Medicine and Clinical Immunology, François Mitterrand Hospital, Dijon University Hospital, Dijon, France.
Clin Exp Rheumatol. 2021 Mar-Apr;39 Suppl 129(2):155-160. doi: 10.55563/clinexprheumatol/0nd4kk. Epub 2021 Apr 30.
Giant cell arteritis (GCA) is the most common primary large-vessel vasculitis. Glucocorticoids (GC) therapy remains the standard of care for GCA despite frequent side effects (SEs). However, treatment modality changes, prophylactic treatment of osteoporosis, or vaccinations might have decreased the frequency of GC-related SEs. This study aims to describe GCA treatment and GC-related SEs in a recent cohort.
Patients with a diagnosis of GCA between May 2009 and March 2018 were included in this multicentric retrospective study. Characteristics of patients, treatment modalities and GC-related SEs were collected and analysed. Risk factors associated with the occurrence of SE were studied.
We analysed the files from 206 patients (153 women, 53 men; median age 74 years). Median follow-up was 34 months. Patients received GC for a median of 25 months, starting at 0.7 mg/kg/day, with tapering to 5 mg/day after 11 months follow-up. Flares occurred in 83/201 (41%) patients. Among the 132 patients who stopped GC, 29 (22%) experienced a relapse. SEs occurred in 129 (64%) patients: bone fractures and infections in 13% each and hypertension onset in 9%. Age >75 years, treatment duration >2 years, past medical history of diabetes were risk factors associated with GC-related SEs.
Flares occur in 41% of patients during GC withdrawal. As much as 64% of patients had treatment related SEs. An age> 75 year and a past medical history of diabetes were predictive of SEs during follow-up.
巨细胞动脉炎（GCA）是最常见的原发性大血管血管炎。尽管糖皮质激素（GC）治疗常有副作用，但仍是GCA的标准治疗方法。然而，治疗方式的改变、骨质疏松症的预防性治疗或疫苗接种可能降低了GC相关副作用的发生率。本研究旨在描述近期队列中GCA的治疗情况及GC相关副作用。
本多中心回顾性研究纳入了2009年5月至2018年3月期间诊断为GCA的患者。收集并分析患者的特征、治疗方式及GC相关副作用。研究与副作用发生相关的危险因素。
我们分析了206例患者（153例女性，53例男性；中位年龄74岁）的病历。中位随访时间为34个月。患者接受GC治疗的中位时间为25个月，起始剂量为0.7mg/kg/天，随访11个月后逐渐减至5mg/天。83/201（41%）例患者出现病情复发。在132例停用GC的患者中，29例（22%）复发。129例（64%）患者出现副作用：骨折和感染各占13%，高血压发生率为9%。年龄>75岁、治疗时间>2年、既往有糖尿病病史是与GC相关副作用相关的危险因素。
41%的患者在GC减量过程中出现病情复发。多达64%的患者有治疗相关副作用。年龄>75岁和既往有糖尿病病史是随访期间副作用的预测因素。
