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Lomba Goncalves N, Tran VT, Chauffier J, Bourdin V, Nassarmadji K, Vanjak A, Bigot W, Burlacu R, Champion K, Lopes A, Depont A, Borrero BA, Mangin O, Adle-Biassette H, Bonnin P, Boutigny A, Bonnin S, Neumann L, Mouly S, Sène D, Comarmond C. [Clinical characteristics and follow-up of 60 patients with recent diagnosis of giant cell arteritis, NEWTON study]. Rev Med Interne 2024; 45:335-342. [PMID: 38216390 DOI: 10.1016/j.revmed.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/05/2023] [Accepted: 12/17/2023] [Indexed: 01/14/2024]
Abstract
INTRODUCTION The management of giant cell arteritis (GCA) has evolved with the arrival of tocilizumab (TCZ) and the use of PET/CT. Our objective is to describe the characteristics and followup of patients with recent diagnosis of GCA in current care. PATIENTS AND METHODS The NEWTON cohort is a monocentric retrospective cohort based on data collected from 60 GCA patients diagnosed between 2017 and 2022 according to the ACR/EULAR 2022 criteria. RESULTS The median age at diagnosis was 73 [68.75; 81] years old. At diagnosis, the main manifestations were unusual temporal headaches in 48 (80 %) and an inflammatory syndrome in 50 (83 %) patients. Temporal artery biopsy confirmed the diagnosis in 49/58 (84 %) patients. Doppler of the temporal arteries found a halo in 12/23 (52 %) patients. The PET/CT found hypermetabolism in 19/43 (44 %) patients. Prednisone was stopped in 17.5 [12.75; 24.25] months. During follow-up, 22 (37 %) patients received TCZ. At least one complication of corticosteroid therapy was observed in 22 (37 %) patients. After a median follow-up of 24 [12; 42] months, 25 (42 %) patients relapsed. At the end of the follow-up, 29 (48.3 %) patients were weaned from corticosteroid therapy and 15 (25 %) were on TCZ. CONCLUSION Despite the increasing use of TCZ in the therapeutic arsenal and of the PET/CT in the imaging tools of GCA patients, relapses and complications of corticosteroid therapy remain frequent, observed in more than a third of patients.
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Affiliation(s)
- N Lomba Goncalves
- Médecine interne, hôpital Lariboisière, université Paris Cité, Paris, France
| | - V-T Tran
- Centre d'épidémiologie clinique, hôpital Hôtel-Dieu, université Paris Cité, Paris, France
| | - J Chauffier
- Médecine interne, hôpital Lariboisière, université Paris Cité, Paris, France
| | - V Bourdin
- Médecine interne, hôpital Lariboisière, université Paris Cité, Paris, France
| | - K Nassarmadji
- Médecine interne, hôpital Lariboisière, université Paris Cité, Paris, France
| | - A Vanjak
- Médecine interne, hôpital Lariboisière, université Paris Cité, Paris, France
| | - W Bigot
- Médecine interne, hôpital Lariboisière, université Paris Cité, Paris, France
| | - R Burlacu
- Médecine interne, hôpital Lariboisière, université Paris Cité, Paris, France
| | - K Champion
- Médecine interne, hôpital Lariboisière, université Paris Cité, Paris, France
| | - A Lopes
- Médecine interne, hôpital Lariboisière, université Paris Cité, Paris, France
| | - A Depont
- Médecine interne, hôpital Lariboisière, université Paris Cité, Paris, France
| | - B A Borrero
- Médecine interne, hôpital Lariboisière, université Paris Cité, Paris, France
| | - O Mangin
- Médecine interne, hôpital Lariboisière, université Paris Cité, Paris, France
| | | | - P Bonnin
- Physiologie, hôpital Lariboisière, Paris, France
| | - A Boutigny
- Physiologie, hôpital Lariboisière, Paris, France
| | - S Bonnin
- Ophtalmologie, hôpital Lariboisière et Fondation Rothschild, Paris, France
| | - L Neumann
- Neurologie, hôpital Lariboisière, Paris, France
| | - S Mouly
- Médecine interne, hôpital Lariboisière, université Paris Cité, Paris, France
| | - D Sène
- Médecine interne, hôpital Lariboisière, université Paris Cité, Paris, France
| | - C Comarmond
- Médecine interne, hôpital Lariboisière, université Paris Cité, Paris, France.
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Nassarmadji K, Vanjak A, Bourdin V, Champion K, Burlacu R, Mouly S, Sène D, Comarmond C. 18-Fluorodeoxyglucose positron emission tomography/computed tomography for large vessel vasculitis in clinical practice. Front Med (Lausanne) 2023; 10:1103752. [PMID: 36744139 PMCID: PMC9892645 DOI: 10.3389/fmed.2023.1103752] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 01/04/2023] [Indexed: 01/20/2023] Open
Abstract
Diagnosis, prognostic assessment, and monitoring disease activity in patients with large vessel vasculitis (LVV) can be challenging. Early recognition of LVV and treatment adaptation is essential because vascular complications (aneurysm, dilatations, ischemic complications) or treatment related side effects can occur frequently in these patients. 18-fluorodeoxyglucose positron emission tomography/computed tomography (2-[18F]FDG-PET/CT) is increasingly used to diagnose, follow, and evaluate treatment response in LVV. In this review, we aimed to summarize the current evidence on the value of 2-[18F]FDG-PET/CT for diagnosis, follow, and treatment monitoring in LVV.
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