ArticleArthritis research & therapy2020
Associated factors of poor treatment outcomes in patients with giant cell arteritis: clinical implication of large vessel lesions.
Article in Arthritis research & therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Biologic therapies for the treatment of large vessel vasculitis: A systematic review and meta-analysis.PloS one · 2025Pooled it
- Evidence on treat to target strategies in polymyalgia rheumatica and giant cell arteritis: a systematic literature review.Rheumatology (Oxford, England) · 2024Pooled it
- Pooled it
- Treatment failure in giant cell arteritis.Annals of the rheumatic diseases · 2021Trial
- Severe infections in giant cell arteritis - incidence over time and relation to large vessel involvement and comorbidities, a population-based study.BMC rheumatology · 2026Article
- Risk factors of serious infections in patients with large-vessel vasculitis after the approval of tocilizumab in 2017: a retrospective nested case-control study using the Japanese health insurance database.Arthritis research & therapy · 2026Observational
- Imaging-guided stratification in giant cell arteritis: prognostic and therapeutic implications.Therapeutic advances in musculoskeletal disease · 2026Review
- Performance of the modified 2022 ACR/EULAR giant cell arteritis classification criteria without age restriction for discriminating from Takayasu arteritis.Arthritis research & therapy · 2025Article
- Comparative analysis of arterial involvement in predominant cranial and isolated extracranial phenotypes of giant cell arteritis usingArthritis research & therapy · 2024Article
- Plasma proteome profiling in giant cell arteritis.Annals of the rheumatic diseases · 2024Article
- Multi-Modality Imaging in Vasculitis.Diagnostics (Basel, Switzerland) · 2024Review
- Glucocorticoid discontinuation rate and risk factors for relapses in a contemporary cohort of patients with giant cell arteritis.Rheumatology international · 2024Article
- The DANIsh VASculitis cohort study: protocol for a national multicenter prospective study including incident and prevalent patients with giant cell arteritis and polymyalgia rheumatica.Frontiers in medicine · 2024Article
- Vascular ultrasound as a follow-up tool in patients with giant cell arteritis: a prospective observational cohort study.Frontiers in medicine · 2024Article
- Review
- Vasculitis distribution and clinical characteristics in giant cell arteritis: a retrospective study using the new 2022 ACR/EULAR classification criteria.Frontiers in medicine · 2023Article
- Biomarkers in the era of targeted therapy in giant cell arteritis and polymyalgia rheumatica: is it possible to replace acute-phase reactants?Frontiers in immunology · 2023Review
- Giant cell arteritis: A population-based retrospective cohort study exploring incidence and clinical presentation in Canterbury, Aotearoa New Zealand.Frontiers in medicine · 2022Article
- Looking ahead: giant-cell arteritis in 10 years time.Therapeutic advances in musculoskeletal disease · 2022Review
- Identification of Acute Giant Cell Arteritis in Real-World Data Using Administrative Claims-Based Algorithms.ACR open rheumatology · 2021Article
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Authors and funding
22 authors at 17 institutions in 1 country.
Funding
Abstract
backgroundRelapses frequently occur in giant cell arteritis (GCA), and long-term glucocorticoid therapy is required. The identification of associated factors with poor treatment outcomes is important to decide the treatment algorithm of GCA.
methodsWe enrolled 139 newly diagnosed GCA patients treated with glucocorticoids between 2007 and 2014 in a retrospective, multi-center registry. Patients were diagnosed with temporal artery biopsy, 1990 American College of Rheumatology classification criteria, or large vessel lesions (LVLs) detected by imaging based on the modified classification criteria. Poor treatment outcomes (non-achievement of clinical remission by week 24 or relapse during 52 weeks) were evaluated. Clinical remission was defined as the absence of clinical signs and symptoms in cranial and large vessel areas, polymyalgia rheumatica (PMR), and elevation of C-reactive protein (CRP) levels. A patient was determined to have a relapse if he/she had either one of the signs and symptoms that newly appeared or worsened after achieving clinical remission. Re-elevation of CRP without clinical manifestations was considered as a relapse if other causes such as infection were excluded and the treatment was intensified. Associated factors with poor treatment outcomes were analyzed by using the Cox proportional hazard model.
resultsCranial lesions, PMR, and LVLs were detected in 77.7%, 41.7%, and 52.5% of the enrolled patients, respectively. Treatment outcomes were evaluated in 119 newly diagnosed patients who were observed for 24 weeks or longer. The mean initial dose of prednisolone was 0.76 mg/kg/day, and 29.4% received any concomitant immunosuppressive drugs at baseline. Overall, 41 (34.5%) of the 119 patients had poor treatment outcomes; 13 did not achieve clinical remission by week 24, and 28 had a relapse after achieving clinical remission. Cumulative rates of the events of poor treatment outcomes in patients with and without LVLs were 47.5% and 17.7%, respectively. A multivariable model showed the presence of LVLs at baseline was significantly associated with poor treatment outcomes (adjusted hazard ratio [HR] 3.54, 95% CI 1.52-8.24, p = 0.003). Cranial lesions and PMR did not increase the risk of poor treatment outcomes.
conclusionThe initial treatment intensity in the treatment algorithm of GCA could be determined based upon the presence or absence of LVLs detected by imaging at baseline.
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