Presentation and Real-World Management of Giant Cell Arteritis (Artemis Study)
Background: Few studies of daily practice for patients with giant cell arteritis (GCA) are available. This French study aimed to describe the characteristics and management of GCA in a real-life setting.Methods: Cross-sectional, non-interventional, multicenter study of patients ≥50 years old who con...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:ed126a2b456c41e480e94c7dc400ec8a2021-11-11T05:56:01ZPresentation and Real-World Management of Giant Cell Arteritis (Artemis Study)2296-858X10.3389/fmed.2021.732934https://doaj.org/article/ed126a2b456c41e480e94c7dc400ec8a2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.732934/fullhttps://doaj.org/toc/2296-858XBackground: Few studies of daily practice for patients with giant cell arteritis (GCA) are available. This French study aimed to describe the characteristics and management of GCA in a real-life setting.Methods: Cross-sectional, non-interventional, multicenter study of patients ≥50 years old who consulted hospital-based specialists for GCA and were under treatment. Patient characteristics and journey, diagnostic methods and treatments were collected. Descriptive analyses were performed.Results: In total, 306 patients (67% females, mean age 74 ± 8 years old) were recruited by 69 physicians (internists: 85%, rheumatologists: 15%); 13% of patients had newly diagnosed GCA (diagnosis-to-visit interval <6 weeks). Overall median disease duration was 13 months (interquartile range 5–26). Most patients were referred by general practitioners (56%), then ophthalmologists (10%) and neurologists (7%). Most common comorbidities were hypertension (46%), psychiatric disorders (10%), dyslipidemia (12%), diabetes (9%), and osteoporosis (6%). Initial GCA presentations included cranial symptoms (89%), constitutional symptoms (74%), polymyalgia rheumatica (48%), and/or other extra-cranial manifestations (35%). Overall, 85, 31, 26, and 30% of patients underwent temporal artery biopsy, high-resolution temporal artery Doppler ultrasonography, 18FDG-PET, and aortic angio-CT, respectively. All patients received glucocorticoids, which were ongoing for 89%; 29% also received adjunct medication(s) (methotrexate: 19%, tocilizumab: 15%). A total of 40% had relapse(s); the median time to the first relapse was 10 months. Also, 37% had comorbidity(ies) related to or aggravated by glucocorticoids therapy.Conclusion: This large observational study provides insight into current medical practices for GCA. More than one third of patients had comorbidities related to glucocorticoid therapy for a median disease duration of 13 months. Methotrexate and tocilizumab were the most common adjunct medications.Alfred MahrEric HachullaHubert de BoyssonNassim GuerrouiEmmanuel HéronStéphane VinzioJonathan BronerFrançois-Xavier LapébieMartin MichaudLaurent SaillerThierry ZenoneMohamed DjeradMathieu JouvrayEmilie ShipleyNathalie TieulieGuillaume ArmengolBastien BouldoiresJean-Francois ViallardIsabelle IdierMarc PaccalinValérie Devauchelle-PensecFrontiers Media S.A.articlegiant cell arteritisphenotype [mesh]management - healthcareobservationalglucocorticoids (GCs)methotrexateMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021) |
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| language |
EN |
| topic |
giant cell arteritis phenotype [mesh] management - healthcare observational glucocorticoids (GCs) methotrexate Medicine (General) R5-920 |
| spellingShingle |
giant cell arteritis phenotype [mesh] management - healthcare observational glucocorticoids (GCs) methotrexate Medicine (General) R5-920 Alfred Mahr Eric Hachulla Hubert de Boysson Nassim Guerroui Emmanuel Héron Stéphane Vinzio Jonathan Broner François-Xavier Lapébie Martin Michaud Laurent Sailler Thierry Zenone Mohamed Djerad Mathieu Jouvray Emilie Shipley Nathalie Tieulie Guillaume Armengol Bastien Bouldoires Jean-Francois Viallard Isabelle Idier Marc Paccalin Valérie Devauchelle-Pensec Presentation and Real-World Management of Giant Cell Arteritis (Artemis Study) |
| description |
Background: Few studies of daily practice for patients with giant cell arteritis (GCA) are available. This French study aimed to describe the characteristics and management of GCA in a real-life setting.Methods: Cross-sectional, non-interventional, multicenter study of patients ≥50 years old who consulted hospital-based specialists for GCA and were under treatment. Patient characteristics and journey, diagnostic methods and treatments were collected. Descriptive analyses were performed.Results: In total, 306 patients (67% females, mean age 74 ± 8 years old) were recruited by 69 physicians (internists: 85%, rheumatologists: 15%); 13% of patients had newly diagnosed GCA (diagnosis-to-visit interval <6 weeks). Overall median disease duration was 13 months (interquartile range 5–26). Most patients were referred by general practitioners (56%), then ophthalmologists (10%) and neurologists (7%). Most common comorbidities were hypertension (46%), psychiatric disorders (10%), dyslipidemia (12%), diabetes (9%), and osteoporosis (6%). Initial GCA presentations included cranial symptoms (89%), constitutional symptoms (74%), polymyalgia rheumatica (48%), and/or other extra-cranial manifestations (35%). Overall, 85, 31, 26, and 30% of patients underwent temporal artery biopsy, high-resolution temporal artery Doppler ultrasonography, 18FDG-PET, and aortic angio-CT, respectively. All patients received glucocorticoids, which were ongoing for 89%; 29% also received adjunct medication(s) (methotrexate: 19%, tocilizumab: 15%). A total of 40% had relapse(s); the median time to the first relapse was 10 months. Also, 37% had comorbidity(ies) related to or aggravated by glucocorticoids therapy.Conclusion: This large observational study provides insight into current medical practices for GCA. More than one third of patients had comorbidities related to glucocorticoid therapy for a median disease duration of 13 months. Methotrexate and tocilizumab were the most common adjunct medications. |
| format |
article |
| author |
Alfred Mahr Eric Hachulla Hubert de Boysson Nassim Guerroui Emmanuel Héron Stéphane Vinzio Jonathan Broner François-Xavier Lapébie Martin Michaud Laurent Sailler Thierry Zenone Mohamed Djerad Mathieu Jouvray Emilie Shipley Nathalie Tieulie Guillaume Armengol Bastien Bouldoires Jean-Francois Viallard Isabelle Idier Marc Paccalin Valérie Devauchelle-Pensec |
| author_facet |
Alfred Mahr Eric Hachulla Hubert de Boysson Nassim Guerroui Emmanuel Héron Stéphane Vinzio Jonathan Broner François-Xavier Lapébie Martin Michaud Laurent Sailler Thierry Zenone Mohamed Djerad Mathieu Jouvray Emilie Shipley Nathalie Tieulie Guillaume Armengol Bastien Bouldoires Jean-Francois Viallard Isabelle Idier Marc Paccalin Valérie Devauchelle-Pensec |
| author_sort |
Alfred Mahr |
| title |
Presentation and Real-World Management of Giant Cell Arteritis (Artemis Study) |
| title_short |
Presentation and Real-World Management of Giant Cell Arteritis (Artemis Study) |
| title_full |
Presentation and Real-World Management of Giant Cell Arteritis (Artemis Study) |
| title_fullStr |
Presentation and Real-World Management of Giant Cell Arteritis (Artemis Study) |
| title_full_unstemmed |
Presentation and Real-World Management of Giant Cell Arteritis (Artemis Study) |
| title_sort |
presentation and real-world management of giant cell arteritis (artemis study) |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/ed126a2b456c41e480e94c7dc400ec8a |
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