González-Gay M A, Ortego-Centeno N, Ercole L
Servicio de Reumatología y Grupo de Investigación sobre la Epidemiología, Genética y Aterosclerosis en Enfermedades Inflamatorias Sistémicas, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Marqués de Valdecilla (IDIVAL), Universidad de Cantabria, Santander, Spain; Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Unidad de Enfermedades Autoinmunes, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada (IBS. Granada), Servicio de Medicina Interna, Universidad de Granada, Granada, Spain.
Rev Clin Esp (Barc). 2022 May;222(5):266-271. doi: 10.1016/j.rceng.2021.02.002. Epub 2021 Oct 5.
The purpose of this study was to learn about the clinical practice of specialists who care for patients with giant cell arteritis, to verify whether they follow the diagnosis and treatment recommendations for this disease, and to identify areas for improvement.
A cross-sectional survey on clinical practice in 2019. The survey was completed by 167 physicians (64% rheumatologists, 27% internal medicine specialists, and 9% other specialists) who attended a course on updating giant cell arteritis treatment. We compared the clinical practice collected in the study with the latest recommendations approved by the European League Against Rheumatism (EULAR).
The physicians surveyed cared for a median of 10 patients (interquartile range 6-30) with giant cell arteritis during their practice. As a diagnostic method, respondents used temporal artery biopsy (84%), temporal artery ultrasound (61%) or other imaging techniques (37%). As first-line therapy, respondents used high-dose glucocorticoids (at least 40 mg of prednisone, or equivalent, per day) (84%), glucocorticoids with methotrexate (7%) and glucocorticoids with tocilizumab (5%). The most frequent drugs used for relapse were methotrexate (37%) and tocilizumab (58%).
Our results indicate that the medical specialists surveyed follow the recent EULAR recommendations for giant cell arteritis diagnosis and therapy.
本研究旨在了解诊治巨细胞动脉炎患者的专科医生的临床实践情况，核实他们是否遵循该疾病的诊断和治疗建议，并确定有待改进的领域。
2019年开展的一项关于临床实践的横断面调查。167名医生（64%为风湿病学家，27%为内科专家，9%为其他专科医生）完成了该调查，他们参加了一次关于更新巨细胞动脉炎治疗方法的课程。我们将研究中收集到的临床实践情况与欧洲抗风湿病联盟（EULAR）批准的最新建议进行了比较。
接受调查的医生在其执业过程中诊治的巨细胞动脉炎患者中位数为10例（四分位间距为6 - 30例）。作为诊断方法，受访者使用颞动脉活检（84%）、颞动脉超声（61%）或其他成像技术（37%）。作为一线治疗方法，受访者使用高剂量糖皮质激素（每天至少40毫克泼尼松或等效药物）（84%）、糖皮质激素联合甲氨蝶呤（7%）以及糖皮质激素联合托珠单抗（5%）。复发时最常用的药物是甲氨蝶呤（37%）和托珠单抗（58%）。
我们的结果表明，接受调查的医学专家遵循了EULAR关于巨细胞动脉炎诊断和治疗的最新建议。
