Giovanna Restuccia1, Luigi Boiardi1, Alberto Cavazza2, Mariagrazia Catanoso1, Pierluigi Macchioni1, Francesco Muratore1, Alessandra Soriano1, Luca Cimino3, Raffaella Aldigeri4, Filippo Crescentini1, Nicolò Pipitone1, Carlo Salvarani5. 1. Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy. 2. Operative Unit of Pathologic Anatomy, Department of Oncology and Advanced Technology, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy. 3. Ophthalmology Unit, Department of Surgery, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy. 4. Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy. 5. Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy. Electronic address: salvarani.carlo@asmn.re.it.
Abstract
OBJECTIVE: To evaluate the frequency of long-term remission after glucocorticoids (GCs) suspension in an Italian cohort of patients with biopsy-proven GCA and to identify factors that may predict long-term remission. METHODS: We evaluated 131 patients with biopsy-proven transmural GCA diagnosed and followed up at the Rheumatology Unit of Reggio Emilia Hospital (Italy) for whom sufficient information was available from the time of diagnosis until at least 18 months of follow-up. Long-term remission was defined as complete clinical remission without elevation of inflammatory markers for at least one year after the GC withdrawal. RESULTS: 73 patients (56%) experienced long-term remission. Disease flares were less frequently observed in patients with long-term remission compared to those without (p = 0.002). The cumulative doses of prednisone at 1 year and for the entire followup duration were significantly lower (p < 0.0001 for both parameters) in patients with long-term remission; similarly, the duration of prednisone treatment was also significantly lower (p < 0.0001). The presence of PMR at diagnosis (HR 0.46) was significantly negatively associated with long-term remission (p = 0.008), while hemoglobin levels (HR 1.48) were significantly positively associated (p < 0.0001). Patients with long-term remission were able to reach 10 mg/day and 5 mg/day of prednisone sooner than the patients without (p = 0.02 and p < 0.0001, respectively). CONCLUSION: In our cohort of GCA patients around half of the patients were able to attain long-term remission. Recognition of findings which predict disease course may aid decisions regarding therapy.
OBJECTIVE: To evaluate the frequency of long-term remission after glucocorticoids (GCs) suspension in an Italian cohort of patients with biopsy-proven GCA and to identify factors that may predict long-term remission. METHODS: We evaluated 131 patients with biopsy-proven transmural GCA diagnosed and followed up at the Rheumatology Unit of Reggio Emilia Hospital (Italy) for whom sufficient information was available from the time of diagnosis until at least 18 months of follow-up. Long-term remission was defined as complete clinical remission without elevation of inflammatory markers for at least one year after the GC withdrawal. RESULTS: 73 patients (56%) experienced long-term remission. Disease flares were less frequently observed in patients with long-term remission compared to those without (p = 0.002). The cumulative doses of prednisone at 1 year and for the entire followup duration were significantly lower (p < 0.0001 for both parameters) in patients with long-term remission; similarly, the duration of prednisone treatment was also significantly lower (p < 0.0001). The presence of PMR at diagnosis (HR 0.46) was significantly negatively associated with long-term remission (p = 0.008), while hemoglobin levels (HR 1.48) were significantly positively associated (p < 0.0001). Patients with long-term remission were able to reach 10 mg/day and 5 mg/day of prednisone sooner than the patients without (p = 0.02 and p < 0.0001, respectively). CONCLUSION: In our cohort of GCA patients around half of the patients were able to attain long-term remission. Recognition of findings which predict disease course may aid decisions regarding therapy.
Authors: Kornelis S M van der Geest; Maria Sandovici; Yannick van Sleen; Jan-Stephan Sanders; Nicolaas A Bos; Wayel H Abdulahad; Coen A Stegeman; Peter Heeringa; Abraham Rutgers; Cees G M Kallenberg; Annemieke M H Boots; Elisabeth Brouwer Journal: Arthritis Rheumatol Date: 2018-07-30 Impact factor: 10.995
Authors: Sara Monti; Ana F Águeda; Raashid Ahmed Luqmani; Frank Buttgereit; Maria Cid; Christian Dejaco; Alfred Mahr; Cristina Ponte; Carlo Salvarani; Wolfgang Schmidt; Bernhard Hellmich Journal: RMD Open Date: 2019-09-16
Authors: Pavlos Stamatis; Aleksandra Turkiewicz; Martin Englund; Carl Turesson; Aladdin J Mohammad Journal: Rheumatology (Oxford) Date: 2021-12-24 Impact factor: 7.580