PT  - JOURNAL ARTICLE
AU  - Anael Dumont
AU  - Jean-Jacques Parienti
AU  - Claire Delmas
AU  - Jonathan Boutemy
AU  - Gwénola Maigné
AU  - Nicolas Martin Silva
AU  - Audrey Sultan
AU  - Gaétane Planchard
AU  - Achille Aouba
AU  - Hubert de Boysson
TI  - Factors Associated with Relapse and Dependence on Glucocorticoids in Giant Cell Arteritis
AID  - 10.3899/jrheum.181127
DP  - 2020 Jan 01
TA  - The Journal of Rheumatology
PG  - 108--116
VI  - 47
IP  - 1
4099  - http://www.jrheum.org/content/47/1/108.short
4100  - http://www.jrheum.org/content/47/1/108.full
SO  - J Rheumatol2020 Jan 01; 47
AB  - Objective. To identify characteristics and factors associated with relapse and glucocorticoid (GC) dependence in patients with giant cell arteritis (GCA).Methods. We retrospectively analyzed 326 consecutive patients with GCA followed for at least 12 months. Factors associated with relapse and GC dependence were identified in multivariable analyses.Results. The 326 patients (73% women) were followed up for 62 (12–262) months. During followup, 171 (52%) patients relapsed, including 113 (35%) who developed GC dependence. Relapsing patients had less history of stroke (p = 0.01) and presented large-vessel vasculitis (LVV) more frequently on imaging (p = 0.01) than patients without relapse. During the first months, therapeutic strategy did not differ among relapsing and nonrelapsing patients. GC-dependent patients were less likely to have a history of stroke (p = 0.004) and presented LVV on imaging more frequently (p = 0.005) than patients without GC-dependent disease. In multivariable analyses, LVV was an independent predictive factor of relapse (HR 1.49, 95% CI 1.002–2.12; p = 0.04) and GC dependence (OR 2.19, 95% CI 1.19–4.05; p = 0.01). Conversely, stroke was a protective factor against relapse (HR 0.21, 95% CI 0.03–0.68; p = 0.005) and GC-dependent disease (OR 0.10, 95% CI 0.001–0.31; p = 0.0005). Patients with a GC-dependent disease who received a GC-sparing agent had a shorter GC treatment duration than those without (p = 0.008).Conclusion. In this study, LVV was an independent predictor of relapse and GC dependence. Further prospective studies are needed to confirm these findings and to determine whether patients with LVV require a different treatment approach.