Giant cell arteritis : intensity of the initial systemic inflammatory response and the course of the disease

Giant cell arteritis (GCA) has a variable course. We assessed whether intensity of initial systemic inflammatory response (ISIR) can predict the course of GCA. Charts of 130 GCA patients were reviewed. ISIR intensity at presentation was determined by 5 parameters of inflammation: sedimentation rate...

Full description

Saved in:
Bibliographic Details
Published in:Clinical and experimental rheumatology 2008-05, Vol.26 (3), p.S30-S34
Main Authors: NESHER, G, NESHER, R, MATES, M, SONNENBLICK, M, BREUER, G. S
Format: Article
Language:English
Subjects:
Adrenal Cortex Hormones - administration & dosage
Aged
Aged, 80 and over
Biological and medical sciences
Bones, joints and connective tissue. Antiinflammatory agents
Cohort Studies
Disease Progression
Diseases of the osteoarticular system
Drug Administration Schedule
Female
Giant Cell Arteritis - drug therapy
Giant Cell Arteritis - physiopathology
Humans
Inflammation - drug therapy
Inflammation - physiopathology
Inflammatory joint diseases
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Polymyalgia Rheumatica - drug therapy
Polymyalgia Rheumatica - physiopathology
Retrospective Studies
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Giant cell arteritis (GCA) has a variable course. We assessed whether intensity of initial systemic inflammatory response (ISIR) can predict the course of GCA. Charts of 130 GCA patients were reviewed. ISIR intensity at presentation was determined by 5 parameters of inflammation: sedimentation rate >100 mm/h, thrombocytosis >400,000/microl, hemoglobin 11000/microl, and fever >37.5 degrees C. Patients were divided into 3 groups according to ISIR intensity: strong (4-5 parameters present, n=24), moderate (2-3 parameters, n=55) and weak ISIR (0-1 parameter, n=51). There were no significant differences between these groups regarding mean age, female:male ratio and the initial prednisone dose. At 1 year, 75% of patients in the strong ISIR group required >5 mg/d of prednisone, compared to 54% and 37% of patients with moderate or weak ISIR, respectively (p=0.015). Disease flares were more common in patients with strong ISIR during a 3-year period, compared to patients with moderate or weak ISIR (77%, 67% and 43%, respectively, p=0.013). Only 33% of patients with strong ISIR were able to discontinue steroids after 3 years, compared to 49% and 77% of patients with moderate and weak ISIR, respectively (p=0.003). GCA Patients with strong ISIR have prolonged disease course with more flares, requiring higher steroid doses. ISIR intensity should be taken into consideration when planning studies evaluating potential steroid-sparing agents, as response to treatment may vary in patients with different ISIR intensities.
ISSN:0392-856X
1593-098X