Clinical practice in giant cell arteritis based on a survey of specialists

2021 ◽  
Author(s):  
M.A. González-Gay ◽  
N. Ortego-Centeno ◽  
L. Ercole
Keyword(s):  
Clinical Practice ◽  
Giant Cell Arteritis ◽  
Giant Cell

scholarly journals AB0551 The impact of temporal artery biopsy on diagnosis of giant cell arteritis in clinical practice

2017 ◽  
Author(s):  
E Kaltsonoudis ◽  
D Kirochristos ◽  
A Bai-Papoudou ◽  
P Voulgari ◽  
AA Drosos
Keyword(s):  
Clinical Practice ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Temporal Artery ◽  
Temporal Artery Biopsy ◽  
The Impact

scholarly journals THU0439 Tocilizumab in giant cell arteritis. national multicenter study of 134 patients of clinical practice

2018 ◽  
Author(s):  
D. Prieto-Peña ◽  
J. Loricera ◽  
J. Martín-V ◽  
M. Calderón-G ◽  
V. Aldasoro ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Multicenter Study

scholarly journals The impact of temporal artery biopsy for the diagnosis of giant cell arteritis in clinical practice in a tertiary university hospital

PLoS ONE ◽  
2019 ◽  
Vol 14 (3) ◽  
pp. e0210845 ◽  
Author(s):  
Evripidis Kaltsonoudis ◽  
Eleftherios Pelechas ◽  
Alexandra Papoudou-Bai ◽  
Theodora E. Markatseli ◽  
Moses Elisaf ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Temporal Artery ◽  
University Hospital ◽  
Temporal Artery Biopsy ◽  
The Impact

scholarly journals THU0309 Treatment with methotrexate and risk of relapses in patients with giant cell arteritis in clinical practice

2017 ◽  
Author(s):  
D Núñez Freites ◽  
J Font ◽  
C Leόn ◽  
I Morado ◽  
L Rodríguez-Rodríguez ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Giant Cell Arteritis ◽  
Giant Cell

scholarly journals Tocilizumab in giant cell arteritis. Observational, open-label multicenter study of 134 patients in clinical practice

2019 ◽  
Vol 49 (1) ◽  
pp. 126-135 ◽  
Author(s):  
Mónica Calderón-Goercke ◽  
Javier Loricera ◽  
Vicente Aldasoro ◽  
Santos Castañeda ◽  
Ignacio Villa ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Multicenter Study ◽  
Open Label

scholarly journals POS0805 TREATMENT OF GIANT CELL ARTERITIS WITH TOCILIZUMAB: A RETROSPECTIVE COHORT STUDY OF 119 PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 655.1-655
Author(s):  
J. Rakholiya ◽  
M. Koster ◽  
H. Langenfeld ◽  
C. S. Crowson ◽  
A. Abril ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Practice ◽  
Adverse Events ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Research Support ◽  
The Mean

Background:Giant cell arteritis (GCA) is an inflammatory condition of medium- and large-sized arteries. Prospective clinical trials have demonstrated the efficacy of tocilizumab (TCZ) for treatment of patients with GCA (1). However, there is a limited data on the use of TCZ in routine clinical practice.Objectives:To evaluate the efficacy and safety of TCZ in a retrospective cohort study of patients with GCA treated with TCZ.Methods:Patients with GCA treated with TCZ at 4 clinical centers of a single tertiary care institution (2000-2020) were identified. The diagnosis of GCA was confirmed by at least one of the following modalities: 1. Arterial biopsy 2. Large vessel imaging 3. Clinical diagnosis of GCA meeting ACR classification criteria and established by a rheumatologist. Patient demographics, clinical presentation, laboratory studies, treatment course and adverse events were abstracted from the medical record; only patients with at least 6 months of follow-up after TCZ initiation were included. Kaplan-Meier methods were used to estimate time to TCZ discontinuation and time to first relapse after TCZ discontinuation. Poisson regression models were used to compare relapse rates before and after TCZ initiation.Results:The study cohort included 119 patients [61% female; mean (SD) age at GCA diagnosis 70.3 (8.2) years]. The majority of patients (89%) had a biopsy-proven and/or imaging-based diagnosis of GCA, while 13 (11%) had a clinical diagnosis of GCA. In addition to glucocorticoids, 40 (34%) patients received other immunosuppressive agents prior to TCZ. The method of initial TCZ administration was subcutaneous (162mg/ml) weekly in 48 (41%), subcutaneous every other week in 20 (17%), monthly 4mg/kg infusions in 34 (29%), monthly 8mg/kg infusions in 14 (12%) and non-standard dosing in 3 remaining patients. The median (IQR) duration from GCA diagnosis to TCZ initiation was 4.8 (1.2-22.0) months and the median (IQR) duration of TCZ treatment was 18 (11-28) months. The mean (SD) dose of prednisone at TCZ initiation was 31 (19) mg/day and was reduced to a mean (SD) dose of 3.9 (6.7) mg/day at TCZ discontinuation/last follow-up visit. The relapse rate per year decreased 43% from 0.77 to 0.44 after the initiation of TCZ (RR=0.57; 95% CI: 0.44-0.75; p<0.001). The mean (SD) ESR and CRP decreased from 22 (20) mm/hour to 6 (9.2) mm/hour and from 19.1 (25) mg/L to 5.4 (16.6) mg/L, respectively from TCZ initiation to TCZ discontinuation/last follow-up visit. At 2 years of follow-up, 67% of patients had discontinued glucocorticoids. At last follow up, 46 patients had discontinued TCZ, only 14 of which were due to adverse events. The median time to TCZ discontinuation was 2.9 years. Only 17% (95%CI: 10-24%) had discontinued by 1 year after TCZ initiation and 38% (95% CI: 26-47%) had discontinued by 2 years. The most common adverse events were infections and cytopenias. While on TCZ, 1 patient developed new onset vision loss related to GCA and 1 patient, without history of diverticulitis, had bowel perforation. Among those discontinuing TCZ, 61% had relapsed at least once by 1 year after TCZ discontinuation.Conclusion:In this large single institution cohort of patients with GCA, TCZ use resulted in a significantly reduced relapse rate and reduction in glucocorticoid dosage. Overall, patients tolerated long-term use with only 12% discontinuing due to adverse events. However, over half of patients stopping TCZ had a subsequent flare; highlighting ongoing use may be required beyond two years in several patients with GCA to maintain remission.References:[1]Stone JH, et al. Trial of Tocilizumab in Giant-Cell Arteritis. N Engl J Med. 2017 Jul 27;377(4):317-328. doi: 10.1056/NEJMoa1613849. PMID: 28745999.[2]Calderón-Goercke M, et al. Tocilizumab in giant cell arteritis. Observational, open-label multicenter study of 134 patients in clinical practice. Semin Arthritis Rheum. 2019 Aug;49(1):126-135. doi: 10.1016/j.semarthrit.2019.01.003. Epub 2019 Jan 5. PMID: 30655091.Disclosure of Interests:Jigisha Rakholiya: None declared, Matthew Koster: None declared, Hannah Langenfeld: None declared, Cynthia S. Crowson: None declared, Andy Abril: None declared, Pankaj Bansal: None declared, Lester Mertz: None declared, Alicia Rodriguez-Pla: None declared, Rahul Sehgal: None declared, Benjamin Wang: None declared, Kenneth J Warrington Grant/research support from: Research support: Kiniksa, Eli Lilly

scholarly journals 274. CLINICAL OUTCOMES OF PATIENTS WITH GIANT CELL ARTERITIS TREATED WITH TOCILIZUMAB IN REAL-WORLD CLINICAL PRACTICE

Rheumatology ◽  
2019 ◽  
Vol 58 (Supplement_2) ◽  
Author(s):  
Sebastian Unizony ◽  
Jinglan Pei ◽  
Paris Sidiropoulos ◽  
Jennie Best ◽  
Christine Birchwood ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Clinical Outcomes ◽  
Real World

scholarly journals Which Patients with Giant Cell Arteritis Will Develop Cardiovascular or Cerebrovascular Disease? A Clinical Practice Research Datalink Study

2016 ◽  
Vol 43 (6) ◽  
pp. 1085-1092 ◽  
Author(s):  
Joanna C. Robson ◽  
Amit Kiran ◽  
Joe Maskell ◽  
Andrew Hutchings ◽  
Nigel Arden ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cerebrovascular Disease ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Risk Model ◽  
Competing Risk ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Increased Risk ◽  
The Uk

Objective.To evaluate the risk of cerebrovascular disease and cardiovascular disease (CVD) in patients with giant cell arteritis (GCA), and to identify predictors.Methods.The UK Clinical Practice Research Datalink 1991–2010 was used for a parallel cohort study of 5827 patients with GCA and 37,090 age-, sex-, and location-matched controls. A multivariable competing risk model (non-cerebrovascular/CV-related death as the competing risk) determined the relative risk [subhazard ratio (SHR)] between patients with GCA compared with background controls for cerebrovascular disease, CVD, or either. Each cohort (GCA and controls) was then analyzed individually using the same multivariable model, with age and sex now present, to identify predictors of CVD or cerebrovascular disease.Results.Patients with GCA, compared with controls, had an increased risk SHR (95% CI) of cerebrovascular disease (1.45, 1.31–1.60), CVD (1.49, 1.37–1.62), or either (1.47, 1.37–1.57). In the GCA cohort, predictors of “cerebrovascular disease or CVD” included increasing age, > 80 years versus < 65 years (1.98, 1.62–2.42), male sex (1.20, 1.05–1.38), and socioeconomic status, most deprived quintile versus least deprived (1.34, 1.01–1.78). These predictors were also present within the non-GCA cohort.Conclusion.Patients with GCA are more likely to develop cerebrovascular disease or CVD than age-, sex-, and location-matched controls. In common with the non-GCA cohort, patients who are older, male, and from the most deprived compared with least deprived areas have a higher risk of cerebrovascular disease or CVD. Further work is needed to understand how this risk may be mediated by specific behavioral, social, and economic factors.

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