Skip to main content

Main menu

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • AV Rheum
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Author Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Accessibility
  • Contact Us
  • JRheum Supplements
  • Services

User menu

  • My Cart
  • Log In

Search

  • Advanced search
The Journal of Rheumatology
  • JRheum Supplements
  • Services
  • My Cart
  • Log In
The Journal of Rheumatology

Advanced Search

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • AV Rheum
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Author Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Accessibility
  • Contact Us
  • Follow jrheum on Twitter
  • Visit jrheum on Facebook
  • Follow jrheum on LinkedIn
  • Follow jrheum on RSS
Research ArticleArticle

Efficacy of Methotrexate in Real-world Management of Giant Cell Arteritis: A Case-control Study

Matthew J. Koster, Karthik Yeruva, Cynthia S. Crowson, Francesco Muratore, Cristian Labarca and Kenneth J. Warrington
The Journal of Rheumatology January 2019, jrheum.180429; DOI: https://doi.org/10.3899/jrheum.180429
Matthew J. Koster
From the Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology, and the Mayo Clinic College of Medicine, Department of Health Sciences Research, Rochester, Minnesota, USA; Division of Rheumatology, Azienda Ospedaliera, Unità Sanitaria Locale–Institute for Research and Health Care (USL-IRCCS) di Reggio Emilia e Università di Modena e Reggio Emilia, Modena e Reggio Emilia, Italy; Universidad Del Desarrollo, Clinica Alemana, Santiago, Chile. M.J. Koster, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology; K. Yeruva, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology; C.S. Crowson, PhD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology, and the Mayo Clinic College of Medicine, Department of Health Sciences Research; F. Muratore, MD, Division of Rheumatology, Azienda Osedaliera, USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia; C. Labarca, MD, Universidad Del Desarrollo, Clinica Alemana; K.J. Warrington, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology. Address correspondence to Dr. M.J. Koster, Mayo Clinic, 200 1st St. SW, Rochester, Minnesota 55905, USA. E-mail: koster.matthew@mayo.edu. Accepted for publication October 10, 2018.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Karthik Yeruva
From the Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology, and the Mayo Clinic College of Medicine, Department of Health Sciences Research, Rochester, Minnesota, USA; Division of Rheumatology, Azienda Ospedaliera, Unità Sanitaria Locale–Institute for Research and Health Care (USL-IRCCS) di Reggio Emilia e Università di Modena e Reggio Emilia, Modena e Reggio Emilia, Italy; Universidad Del Desarrollo, Clinica Alemana, Santiago, Chile. M.J. Koster, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology; K. Yeruva, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology; C.S. Crowson, PhD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology, and the Mayo Clinic College of Medicine, Department of Health Sciences Research; F. Muratore, MD, Division of Rheumatology, Azienda Osedaliera, USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia; C. Labarca, MD, Universidad Del Desarrollo, Clinica Alemana; K.J. Warrington, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology. Address correspondence to Dr. M.J. Koster, Mayo Clinic, 200 1st St. SW, Rochester, Minnesota 55905, USA. E-mail: koster.matthew@mayo.edu. Accepted for publication October 10, 2018.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Cynthia S. Crowson
From the Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology, and the Mayo Clinic College of Medicine, Department of Health Sciences Research, Rochester, Minnesota, USA; Division of Rheumatology, Azienda Ospedaliera, Unità Sanitaria Locale–Institute for Research and Health Care (USL-IRCCS) di Reggio Emilia e Università di Modena e Reggio Emilia, Modena e Reggio Emilia, Italy; Universidad Del Desarrollo, Clinica Alemana, Santiago, Chile. M.J. Koster, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology; K. Yeruva, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology; C.S. Crowson, PhD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology, and the Mayo Clinic College of Medicine, Department of Health Sciences Research; F. Muratore, MD, Division of Rheumatology, Azienda Osedaliera, USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia; C. Labarca, MD, Universidad Del Desarrollo, Clinica Alemana; K.J. Warrington, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology. Address correspondence to Dr. M.J. Koster, Mayo Clinic, 200 1st St. SW, Rochester, Minnesota 55905, USA. E-mail: koster.matthew@mayo.edu. Accepted for publication October 10, 2018.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Francesco Muratore
From the Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology, and the Mayo Clinic College of Medicine, Department of Health Sciences Research, Rochester, Minnesota, USA; Division of Rheumatology, Azienda Ospedaliera, Unità Sanitaria Locale–Institute for Research and Health Care (USL-IRCCS) di Reggio Emilia e Università di Modena e Reggio Emilia, Modena e Reggio Emilia, Italy; Universidad Del Desarrollo, Clinica Alemana, Santiago, Chile. M.J. Koster, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology; K. Yeruva, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology; C.S. Crowson, PhD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology, and the Mayo Clinic College of Medicine, Department of Health Sciences Research; F. Muratore, MD, Division of Rheumatology, Azienda Osedaliera, USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia; C. Labarca, MD, Universidad Del Desarrollo, Clinica Alemana; K.J. Warrington, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology. Address correspondence to Dr. M.J. Koster, Mayo Clinic, 200 1st St. SW, Rochester, Minnesota 55905, USA. E-mail: koster.matthew@mayo.edu. Accepted for publication October 10, 2018.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Cristian Labarca
From the Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology, and the Mayo Clinic College of Medicine, Department of Health Sciences Research, Rochester, Minnesota, USA; Division of Rheumatology, Azienda Ospedaliera, Unità Sanitaria Locale–Institute for Research and Health Care (USL-IRCCS) di Reggio Emilia e Università di Modena e Reggio Emilia, Modena e Reggio Emilia, Italy; Universidad Del Desarrollo, Clinica Alemana, Santiago, Chile. M.J. Koster, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology; K. Yeruva, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology; C.S. Crowson, PhD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology, and the Mayo Clinic College of Medicine, Department of Health Sciences Research; F. Muratore, MD, Division of Rheumatology, Azienda Osedaliera, USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia; C. Labarca, MD, Universidad Del Desarrollo, Clinica Alemana; K.J. Warrington, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology. Address correspondence to Dr. M.J. Koster, Mayo Clinic, 200 1st St. SW, Rochester, Minnesota 55905, USA. E-mail: koster.matthew@mayo.edu. Accepted for publication October 10, 2018.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kenneth J. Warrington
From the Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology, and the Mayo Clinic College of Medicine, Department of Health Sciences Research, Rochester, Minnesota, USA; Division of Rheumatology, Azienda Ospedaliera, Unità Sanitaria Locale–Institute for Research and Health Care (USL-IRCCS) di Reggio Emilia e Università di Modena e Reggio Emilia, Modena e Reggio Emilia, Italy; Universidad Del Desarrollo, Clinica Alemana, Santiago, Chile. M.J. Koster, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology; K. Yeruva, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology; C.S. Crowson, PhD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology, and the Mayo Clinic College of Medicine, Department of Health Sciences Research; F. Muratore, MD, Division of Rheumatology, Azienda Osedaliera, USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia; C. Labarca, MD, Universidad Del Desarrollo, Clinica Alemana; K.J. Warrington, MD, Mayo Clinic College of Medicine and Science, Department of Internal Medicine, Division of Rheumatology. Address correspondence to Dr. M.J. Koster, Mayo Clinic, 200 1st St. SW, Rochester, Minnesota 55905, USA. E-mail: koster.matthew@mayo.edu. Accepted for publication October 10, 2018.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • References
  • Info & Metrics
  • PDF
  • eLetters
Next
Loading

Abstract

Objective To determine the effect of methotrexate (MTX) on relapse risk and glucocorticoid (GC) use in a large single-institution cohort of patients with giant cell arteritis (GCA).

Methods Patients diagnosed with GCA from 1998 to 2013 with confirmed evidence of temporal artery biopsy and/or radiographic evidence of large vessel vasculitis were identified. Each patient with GCA treated with adjunct MTX (case) was matched to a similar patient with GCA treated only with GC (control). GC requirements and relapse events before and after MTX initiation (or corresponding index date) were compared using rate ratios (RR).

Results Eighty-three cases and 83 controls were identified and compared. No significant differences in age, demographics, laboratory variables, baseline disease characteristics, or mean initial prednisone doses were observed. Median [interquartile range (IQR)] time from GCA diagnosis to MTX initiation in cases was 39 (13–80) weeks and the median (IQR) starting dose was 13.5 (10–15) mg/week. RR comparing relapse rates before and after MTX initiation/index date were significantly reduced in both cases (RR 0.32, 95% CI 0.24–0.41) and controls (RR 0.60, 95% CI 0.43–0.86). The decrease in relapse rate was significantly greater in patients taking MTX than in those taking GC alone (p = 0.004). Rates of GC discontinuation did not differ between groups.

Conclusion In this large single-institution cohort, the addition of MTX to GC decreased the rate of subsequent relapse by nearly 2-fold compared to patients taking GC alone. MTX may be considered as adjunct therapy in patients with GCA to decrease the risk of further relapse events.

Log in using your username and password

Forgot your user name or password?

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.
Next
Back to top

In this issue

The Journal of Rheumatology
Vol. 46, Issue 12
1 Dec 2019
  • Table of Contents
  • Table of Contents (PDF)
  • Index by Author
  • Editorial Board (PDF)
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about The Journal of Rheumatology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Efficacy of Methotrexate in Real-world Management of Giant Cell Arteritis: A Case-control Study
(Your Name) has forwarded a page to you from The Journal of Rheumatology
(Your Name) thought you would like to see this page from the The Journal of Rheumatology web site.
Citation Tools
Efficacy of Methotrexate in Real-world Management of Giant Cell Arteritis: A Case-control Study
Matthew J. Koster, Karthik Yeruva, Cynthia S. Crowson, Francesco Muratore, Cristian Labarca, Kenneth J. Warrington
The Journal of Rheumatology Jan 2019, jrheum.180429; DOI: 10.3899/jrheum.180429

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

 Request Permissions

Share
Efficacy of Methotrexate in Real-world Management of Giant Cell Arteritis: A Case-control Study
Matthew J. Koster, Karthik Yeruva, Cynthia S. Crowson, Francesco Muratore, Cristian Labarca, Kenneth J. Warrington
The Journal of Rheumatology Jan 2019, jrheum.180429; DOI: 10.3899/jrheum.180429
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Save to my folders

Jump to section

  • Article
  • References
  • Info & Metrics
  • PDF
  • eLetters

Related Articles

Cited By...

More in this TOC Section

  • Neutrophil Extracellular Traps Profiles in Patients with Incident Systemic Lupus Erythematosus and Lupus Nephritis
  • Suboptimal Immunization Coverage among Canadian Rheumatology Patients in Routine Clinical Care
  • Changes in the Presentation of Incident Gout and the Risk of Subsequent Flares: A Population-based Study over 20 Years
Show more Articles

Similar Articles

Content

  • First Release
  • Current
  • Archives
  • Collections
  • AV Rheum

Resources

  • Guide for Authors
  • Submit Manuscript
  • Author Payment
  • Reviewers
  • Advertisers
  • Classified Ads
  • Reprints and Translations
  • Permissions
  • Meetings
  • FAQ
  • Policies

Subscribers

  • Subscription Information
  • Purchase Subscription
  • Your Account
  • Terms and Conditions

More

  • About Us
  • Contact Us
  • My Alerts
  • My Folders
  • RSS Feeds
The Journal of Rheumatology
The content of this site is intended for health care professionals.
Copyright © 2016 by The Journal of Rheumatology Publishing Co. Ltd.
Print ISSN: 0315-162X; Online ISSN: 1499-2752
Powered by HighWire