The following is a summary of “Predictors of Relapses or Recurrences in Patients With Giant Cell Arteritis,” published in the June 2023 issue of Rheumatology by Pinho, et al.
The most prevalent type of systemic vasculitis in those aged ≥50 is giant cell arteritis (GCA). Its high recurrence rate necessitates long-term glucocorticoid use, which has intrinsic drawbacks. For a study, researchers sought to identify factors associated with relapses or recurrences in patients with GCA at the time of diagnosis.
The medical records of consecutive patients diagnosed with GCA between 2009 and 2019 and followed for at least 12 months were reviewed. Patient characteristics at onset and during follow-up were recorded. Multivariable analysis was used to find the variables connected to relapses or recurrences.
A total of 153 patients were included in the study, with 68% female and a median age of 73 (47–98) years. The median follow-up duration was 32 (12–142) months. Among the patients, 74 patients (48.4%) experienced at least one relapse or recurrence. Headache and polymyalgia rheumatica were the most common manifestations of relapses. The first relapse occurred 13 months after diagnosis, with a median glucocorticoid dose of 5.5 (0–25) mg/day.
In the multivariable analysis, patients with relapses or recurrences had a higher frequency of cough and scalp tenderness at the time of diagnosis compared to those without relapses (20.3% vs. 5.1%; odds ratio [OR], 4.73; 95% CI, 1.25-17.94; P= 0.022; and 41.9% vs. 29.1%; OR, 2.4; 95% CI, 1.07-5.39; P = 0.034, respectively). Additionally, patients with diabetes mellitus at diagnosis had a lower incidence of relapses or recurrences during follow-up (5.4% vs. 19%; OR, 0.24; 95% CI, 0.07-0.83; P = 0.024).
Cough and scalp tenderness at the time of GCA diagnosis was associated with an increased risk of relapses or recurrences. Conversely, patients with diabetes mellitus had fewer relapses or recurrences during follow-up. The findings highlighted the importance of identifying these factors to better predict and manage relapses in GCA patients.