Clinical Features and Outcomes of Japanese Patients with Giant Cell Arteritis: A Comparison with Takayasu Arteritis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Clinical Evaluations
2.3. Statistical Analysis
3. Results
3.1. Baseline Characteristics of Patients with GCA and TA
3.2. Survival Rates for Patients with GCA and TA
3.3. Relapse-Free Survival Rates for Patients with GCA and TA
3.4. Incidence of Cardiovascular Events in Patients with GCA and TA
3.5. Tapering of GC Dose
3.6. GC Tapering According to the Presence of LVI or Concomitant Use of Immunosuppressant in GCA Patients
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
GCA: | giant cell arteritis |
TA: | Takayasu arteritis |
LVI: | large vessel involvement |
ACR: | American College of Rheumatology |
JCS: | Japanese Circulation Society |
ESR: | erythrocyte sedimentation rate |
CRP: | C-reactive protein |
EULAR: | European Alliance of Associations for Rheumatology |
LVV: | large vessel vasculitis |
GCs: | glucocorticoids |
MTX: | methotrexate |
TCZ: | tocilizumab |
PSL: | prednisolone |
GiACTA: | Giant Cell Arteritis ACTEMRA |
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Characteristics | GCA (n = 15) | TA (n = 30) | p-Value |
---|---|---|---|
Male, n (%) | 4 (26.7) | 4 (13.3) | 0.270 |
Age at onset (years), median (range) | 77 (57–89) | 24 (16–72) | <0.001 * |
Follow-up period (months), median (range) | 25 (3–121) | 58 (7–122) | 0.073 |
Entire treatment period (months), median (range) | 25 (3-121) | 58 (7-222) | 0.073 |
Hypertension, n (%) | 9 (60) | 2 (6.7) | <0.001 * |
Arterial stenosis, n (%) | 0 (0) | 8 (26.6) | 0.027 * |
Aneurysm, n (%) | 2 (13.3) | 2 (6.7) | 0.459 |
Arterial involvement, n (%) | 7 (46.7) | 30 (100) | <0.001 * |
Carotid artery, n (%) | 4 (26.7) | 23 (76.7) | 0.001 * |
Vertebral artery, n (%) | 0 (0) | 0 (0) | |
Subclavian artery, n (%) | 0 (0) | 13 (43.3) | 0.002 * |
Axillary artery, n (%) | 0 (0) | 0 (0) | |
Ascending aorta, n (%) | 2 (13.3) | 20 (66.7) | 0.001 * |
Descending aorta, n (%) | 5 (33.3) | 7 (23.3) | 0.475 |
Abdominal aorta, n (%) | 3 (20) | 7 (23.3) | 0.8 |
Celiac artery, n (%) | 0 (0) | 0 (0) | |
Superior mesenteric artery, n (%) | 1 (6.7) | 1 (3.3) | 0.609 |
Renal artery, n (%) | 0 (0) | 5 (16.7) | 0.094 |
Initial dose of prednisolone (mg/day), median (range) | 30 (10–40) | 40 (0–60) | 0.187 |
Steroid pulse therapy, n (%) | 1 (6.7) | 9 (30) | 0.076 |
Autoimmune comorbidities, n (%) | 1 (6.7) | 6 (20) | 0.245 |
Immunosuppressants, n (%) | 2 (13.3) | 7 (23.3) | 0.429 |
TCZ, n (%) | 4 (26.6) | 15 (50) | 0.135 |
Death, n (%) | 2 (13.3) | 1 (3.3) | 0.205 |
ESR (mm/1st hour), median (range) | 65 (22-95) | 56 (27–111) | 0.488 |
CRP (mg/dl), median (range) | 6.09 (0.33–21.31) | 6.30 (0.2–35.09) | 0.951 |
Relapse during the entire treatment period, n (%) | 1 (6.7) | 16 (53.3) | 0.002 * |
Relapse rate (per 100 person years), n | 1.88 | 14.49 | |
Rate ratio, (95% CI) | 6.78 (1.39-162.93) | 0.013 * |
Characteristics | Value |
---|---|
Number, n | 15 |
ACR criteria for active disease, n (%) | |
Age at disease onset ≥ 50 years | 15 (100) |
New headache | 15 (100) |
Temporal artery abnormality | 11 (73.3) |
Elevated ESR | 15 (100) |
Abnormal temporal artery biopsy | 4 (26.7) |
PMR involvement, n (%) | 7 (46.7) |
Aches or pain in shoulders, n/7 (%) | 5/7 (71.4) |
Aches or pain in the neck, upper arms, buttocks, hips, or thighs, n (%) | 6/7 (85.7) |
Stiffness in affected areas, n (%) | 5/7 (71.4) |
Limited range of motion in affected areas, n (%) | 2/7 (28.6) |
Mild fever, n (%) | 5/7 (71.4) |
Fatigue, n (%) | 4/7 (57.1) |
Unintended weight loss, n (%) | 6/7 (85.7) |
Depression, n (%) | 4/7 (57.1) |
Ischemic optic neuropathy, n (%) | 0 (0) |
Aortic regurgitation, n (%) | 1 (6.7) |
Malignancy, n (%) | 2 (13.3) |
Characteristics | Value |
---|---|
Number, n | 30 |
HLA typing | |
HLA-B52 positive, n/patients HLA tested (%) | 7/25 (28.0) |
Classification of Takayasu arteritis, n (%) | |
I | 8 (26.7) |
IIA | 6 (20) |
IIB | 6 (20) |
III | 0 (0) |
IV | 0 (0) |
V | 10 (33.3) |
Characteristics | LVI(+) (n = 7) | LVI(−) (n = 8) | p-Value |
---|---|---|---|
Male, n (%) | 2 (28.6) | 2 (25.0) | 0.876 |
Age at onset (years), median (range) | 80 (57–89) | 76 (65–86) | 0.598 |
Entire treatment period (months), median (range) | 29 (15–121) | 17 (3–109) | 0.619 |
ACR criteria for active disease | |||
Age at disease onset ≧ 50 years | 7 (100) | 8 (100) | |
New headache | 7 (100) | 8 (100) | |
Temporal artery abnormality | 4 (57.1) | 7 (87.5) | 0.185 |
Elevated ESR | 7 (100) | 8 (100) | |
Abnormal temporal artery biopsy | 2 (28.6) | 2 (25.0) | 0.876 |
PMR, n (%) | 2 (28.6) | 5 (62.5) | 0.189 |
Hypertension, n (%) | 6 (85.7) | 3 (37.5) | 0.057 |
Malignancy, n (%) | 0 (0) | 2 (25.0) | 0.155 |
Steroid pulse therapy, n (%) | 1 (14.3) | 0 (0) | 0.268 |
Initial dose of prednisolone (mg/day), median (range) | 30 (20–40) | 30 (10–40) | 0.875 |
Immunosuppressants, n (%) | 0 (0) | 2 (25.0) | 0.155 |
TCZ, n (%) | 4 (57.1) | 0 (0) | 0.013 * |
Death, n (%) | 0 (0) | 2 (25.0) | 0.155 |
Relapse, n (%) | 0 (0) | 1 (12.5) | 0.333 |
ESR (mm/1st hour), median (range) | 59 (22–95) | 70.5 (36–88) | 0.557 |
CRP (mg/dl), median (range) | 3.77 (0.99–9.76) | 13.3 (0.3321.34) | 0.009 * |
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Yoshida, S.; Suzuki, E.; Sumichika, Y.; Saito, K.; Matsumoto, H.; Temmoku, J.; Fujita, Y.; Matsuoka, N.; Asano, T.; Sato, S.; et al. Clinical Features and Outcomes of Japanese Patients with Giant Cell Arteritis: A Comparison with Takayasu Arteritis. J. Pers. Med. 2023, 13, 387. https://doi.org/10.3390/jpm13030387
Yoshida S, Suzuki E, Sumichika Y, Saito K, Matsumoto H, Temmoku J, Fujita Y, Matsuoka N, Asano T, Sato S, et al. Clinical Features and Outcomes of Japanese Patients with Giant Cell Arteritis: A Comparison with Takayasu Arteritis. Journal of Personalized Medicine. 2023; 13(3):387. https://doi.org/10.3390/jpm13030387
Chicago/Turabian StyleYoshida, Shuhei, Eiji Suzuki, Yuya Sumichika, Kenji Saito, Haruki Matsumoto, Jumpei Temmoku, Yuya Fujita, Naoki Matsuoka, Tomoyuki Asano, Shuzo Sato, and et al. 2023. "Clinical Features and Outcomes of Japanese Patients with Giant Cell Arteritis: A Comparison with Takayasu Arteritis" Journal of Personalized Medicine 13, no. 3: 387. https://doi.org/10.3390/jpm13030387