Abstract
Objectives
To study the clinical features of polymyalgia rheumatica and/or giant cell arteritis (PMR/GCA) and clinical predictors of treatment response during a 40-week follow-up period.
Method
Clinical data on 77 patients with newly diagnosed PMR/GCA who were treated by oral glucocorticoids were gathered at baseline and during 40-week follow-up period. A unilateral temporal artery biopsy (TAB) and 18 F-FDG PET/CT were undertaken at diagnosis. In total, each patient was seen at 5 occasions i.e. baseline, weeks 4, 16, 28, and 40. Treatment response was assessed considering clinical evaluations and results of inflammatory markers.
Results
Of 77 patients (49(63.6%) female, mean age : 71.8 ± 8.0), 64(83.1%) patients had pure PMR, 10(13.0%) concomitant PMR and GCA, and 3(3.9%) pure GCA. The patients reported clinical symptoms except scalp pain and duration of morning stiffness improved significantly at week 4 and remained lower at week 40 compared with the relative frequencies at baseline. Besides, all components of physical examination showed significant improvement and remained lower at week 40 compared with the baseline.
68.7%, 62.9%, 44.1% and 33.3% of the patients had a complete response at weeks 4, 16, 28, and 40, respectively. Several clinical features including female gender, younger age, fewer relapse, and lower level of baseline ESR were significantly associated with a better treatment response. Treatment response during follow-up period was independent of TAB results and FDG uptakes on 18 F-FDG PET/CT at diagnosis.
Conclusion
Obtaining valid disease specific outcome measures for evaluating treatment efficacy in PMR and GCA, that can be applied universally is clearly an unmet clinical need.
Trial registration
ClinicalTrials.gov, https://clinicaltrials.gov, NCT02985424
Clinical presentation and treatment response in patients with polymyalgia rheumatica and giant cell arteritis during a 40-week follow-up
