Prognostic impacts of glucocorticoid treatment in patients with polymyalgia rheumatica and giant cell arteritis

Abstract Identifying comorbidities in polymyalgia rheumatica/giant cell arteritis (PMR/GCA) is crucial for patients’ outcomes. The present study aimed to evaluate the impact of the inflammatory process and glucocorticoid treatment on aortic arterial stiffness and body composition in PMR/GCA. 77 pati...

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Autores principales:	Amir Emamifar, Torkell Ellingsen, Anne Pernille Hermann, Søren Hess, Oke Gerke, Ziba Ahangarani Farahani, Per Syrak Hansen, Inger Marie Jensen Hansen, Peter Thye-Rønn
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/317f1d68ee1a47c181f361d374893342
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spelling	oai:doaj.org-article:317f1d68ee1a47c181f361d3748933422021-12-02T17:05:46ZPrognostic impacts of glucocorticoid treatment in patients with polymyalgia rheumatica and giant cell arteritis10.1038/s41598-021-85857-42045-2322https://doaj.org/article/317f1d68ee1a47c181f361d3748933422021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-85857-4https://doaj.org/toc/2045-2322Abstract Identifying comorbidities in polymyalgia rheumatica/giant cell arteritis (PMR/GCA) is crucial for patients’ outcomes. The present study aimed to evaluate the impact of the inflammatory process and glucocorticoid treatment on aortic arterial stiffness and body composition in PMR/GCA. 77 patients with newly diagnosed PMR/GCA were treated with oral glucocorticoids and followed for 40 weeks. Aortic pulse wave velocity (PWV) was measured at baseline and during the follow-up period and compared to the results of temporal artery biopsy (TAB) and 18F-FDG PET/CT. Body composition was assessed by total body DXA at baseline and the end of the study. Of 77 patients (49 (63.6%) female, mean of age: (71.8 ± 8.0)), 64 (83.1%) had pure PMR, 10 (13.0%) concomitant PMR and GCA, and 3 (3.9%) pure GCA. Compared to baseline values, aortic PWV was initially decreased at week 16 (p = 0.010) and remained lower than baseline at week 28 (p = 0.002) and week 40 (p < 0.001), with no association with results of TAB and 18F-FDG PET/CT. Aortic PWV was significantly associated with age, male gender, left systolic and diastolic blood pressure, right diastolic blood pressure, and CRP. Total bone mineral content (BMC) was decreased in both genders (p < 0.001), while fat mass (FM) was significantly increased (p < 0.001). However, lean body mass did not significantly change during the study. Changes in FM were correlated with cumulative prednisolone dose (rho: 0.26, p = 0.031). Glucocorticoid treatment of patients with PMR/GCA had several prognostic impacts. Arterial stiffness was decreased due either to the treatment or a reduction in the inflammatory load. Additionally, treatment led to changes in body composition, including a decrease in BMC and FM excess.Amir EmamifarTorkell EllingsenAnne Pernille HermannSøren HessOke GerkeZiba Ahangarani FarahaniPer Syrak HansenInger Marie Jensen HansenPeter Thye-RønnNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Amir Emamifar Torkell Ellingsen Anne Pernille Hermann Søren Hess Oke Gerke Ziba Ahangarani Farahani Per Syrak Hansen Inger Marie Jensen Hansen Peter Thye-Rønn Prognostic impacts of glucocorticoid treatment in patients with polymyalgia rheumatica and giant cell arteritis
description	Abstract Identifying comorbidities in polymyalgia rheumatica/giant cell arteritis (PMR/GCA) is crucial for patients’ outcomes. The present study aimed to evaluate the impact of the inflammatory process and glucocorticoid treatment on aortic arterial stiffness and body composition in PMR/GCA. 77 patients with newly diagnosed PMR/GCA were treated with oral glucocorticoids and followed for 40 weeks. Aortic pulse wave velocity (PWV) was measured at baseline and during the follow-up period and compared to the results of temporal artery biopsy (TAB) and 18F-FDG PET/CT. Body composition was assessed by total body DXA at baseline and the end of the study. Of 77 patients (49 (63.6%) female, mean of age: (71.8 ± 8.0)), 64 (83.1%) had pure PMR, 10 (13.0%) concomitant PMR and GCA, and 3 (3.9%) pure GCA. Compared to baseline values, aortic PWV was initially decreased at week 16 (p = 0.010) and remained lower than baseline at week 28 (p = 0.002) and week 40 (p < 0.001), with no association with results of TAB and 18F-FDG PET/CT. Aortic PWV was significantly associated with age, male gender, left systolic and diastolic blood pressure, right diastolic blood pressure, and CRP. Total bone mineral content (BMC) was decreased in both genders (p < 0.001), while fat mass (FM) was significantly increased (p < 0.001). However, lean body mass did not significantly change during the study. Changes in FM were correlated with cumulative prednisolone dose (rho: 0.26, p = 0.031). Glucocorticoid treatment of patients with PMR/GCA had several prognostic impacts. Arterial stiffness was decreased due either to the treatment or a reduction in the inflammatory load. Additionally, treatment led to changes in body composition, including a decrease in BMC and FM excess.
format	article
author	Amir Emamifar Torkell Ellingsen Anne Pernille Hermann Søren Hess Oke Gerke Ziba Ahangarani Farahani Per Syrak Hansen Inger Marie Jensen Hansen Peter Thye-Rønn
author_facet	Amir Emamifar Torkell Ellingsen Anne Pernille Hermann Søren Hess Oke Gerke Ziba Ahangarani Farahani Per Syrak Hansen Inger Marie Jensen Hansen Peter Thye-Rønn
author_sort	Amir Emamifar
title	Prognostic impacts of glucocorticoid treatment in patients with polymyalgia rheumatica and giant cell arteritis
title_short	Prognostic impacts of glucocorticoid treatment in patients with polymyalgia rheumatica and giant cell arteritis
title_full	Prognostic impacts of glucocorticoid treatment in patients with polymyalgia rheumatica and giant cell arteritis
title_fullStr	Prognostic impacts of glucocorticoid treatment in patients with polymyalgia rheumatica and giant cell arteritis
title_full_unstemmed	Prognostic impacts of glucocorticoid treatment in patients with polymyalgia rheumatica and giant cell arteritis
title_sort	prognostic impacts of glucocorticoid treatment in patients with polymyalgia rheumatica and giant cell arteritis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/317f1d68ee1a47c181f361d374893342
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Prognostic impacts of glucocorticoid treatment in patients with polymyalgia rheumatica and giant cell arteritis

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