NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, Maryland.
NIH/Radiology and Imaging Sciences, Bethesda, Maryland.
Arthritis Care Res (Hoboken). 2023 Jun;75(6):1362-1370. doi: 10.1002/acr.24976. Epub 2023 Jan 5.
To examine and compare disease activity over time in giant cell arteritis (GCA) and Takayasu arteritis (TAK) using multimodal assessment combining clinical, laboratory, and imaging-based testing.
Patients with GCA or TAK were enrolled into a single-center prospective, observational cohort at any point in the disease course. Patients underwent standardized assessment, including F-fluorodeoxyglucose positron emission tomography (FDG-PET) at enrollment and follow-up visits. Each FDG-PET finding was subjectively interpreted as active or inactive vasculitis. Global arterial FDG uptake was quantified by the PET Vascular Activity Score (PETVAS). Patients were stratified by disease duration at enrollment (0-2 years; 2-5 years; >5 years). Fisher exact and Mann-Whitney U tests, Spearman's correlation, and linear regression were used for statistical analyses.
A total of 126 patients with large vessel vasculitis (GCA = 50; TAK = 76) were evaluated across 319 visits. Clinical disease activity was present in 33% of patients in the second to fifth year of disease and in 24% of patients evaluated >5 years after diagnosis. Active vasculitis by PET was observed in 66% of patients in years 2 to 5 after diagnosis and in 50% of patients enrolled >5 years into disease. PETVASs were consistently higher in GCA than TAK in the early and later phases of disease and significantly decreased over time in GCA but not TAK. Correlations between clinical, laboratory, and imaging findings were complex and varied with disease duration.
Disease activity in GCA and TAK is common throughout the disease course. Patterns of vascular PET activity at diagnosis and later in disease differ between GCA and TAK.
通过结合临床、实验室和影像学检查的多模态评估，研究和比较巨细胞动脉炎（GCA）和 Takayasu 动脉炎（TAK）随时间推移的疾病活动。
在疾病的任何阶段，将 GCA 或 TAK 患者纳入单中心前瞻性观察队列。患者接受标准化评估，包括在入组和随访时进行 F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）。每个 FDG-PET 发现均被主观解释为活动性或非活动性血管炎。通过 PET 血管活性评分（PETVAS）量化动脉的总体 FDG 摄取。根据入组时的疾病持续时间（0-2 年；2-5 年；>5 年）对患者进行分层。Fisher 确切检验和 Mann-Whitney U 检验、Spearman 相关分析和线性回归用于统计分析。
共评估了 319 次就诊的 126 例大血管血管炎患者（GCA=50；TAK=76）。在疾病的第 2 至第 5 年和诊断后>5 年接受评估的患者中，分别有 33%和 24%存在临床疾病活动。在诊断后 2 至 5 年，有 66%的患者出现 PET 阳性的活动性血管炎，在诊断后>5 年入组的患者中有 50%出现这种情况。在疾病的早期和晚期，GCA 的 PETVAS 始终高于 TAK，并且在 GCA 中随时间显著降低，但在 TAK 中没有。临床、实验室和影像学检查结果之间的相关性复杂且随疾病持续时间而变化。
GCA 和 TAK 的疾病活动在整个病程中都很常见。在诊断时和疾病后期，GCA 和 TAK 的血管 PET 活性模式不同。
