E. E. Fedorinova, N. M. Bulanov, A. D. Meshkov, O. O. Borodin, I. O. Smitienko, E. V. Chachilo, A. A. Nartov, A. L. Filatova, A. V. Naumov, P. I. Novikov, S. V. Moiseev
{"title":"巨细胞动脉炎的临床表现和预后：一项回顾性队列研究","authors":"E. E. Fedorinova, N. M. Bulanov, A. D. Meshkov, O. O. Borodin, I. O. Smitienko, E. V. Chachilo, A. A. Nartov, A. L. Filatova, A. V. Naumov, P. I. Novikov, S. V. Moiseev","doi":"10.1134/S1607672924700984","DOIUrl":null,"url":null,"abstract":"<p>The aim of the study was to evaluate the clinical manifestations and survival of patients with giant cell arteritis (GCA).</p><p><b>.</b> A retrospective study included 166 patients with newly diagnosed GCA. Clinical, laboratory, and instrumental data and three sets of classification criteria were used to confirm the diagnosis: the American College of Rheumatology (ACR) 1990, the revised ACR criteria of 2016 and/or the new ACR and European Alliance of Rheumatologic Associations (EULAR) 2022 criteria. Some of the patients underwent instrumental investigations: temporal artery ultrasound Doppler (<i>n</i> = 61), contrast-enhanced computed tomography (<i>n</i> = 5), CT angiography (<i>n</i> = 6), magnetic resonance imaging (<i>n</i> = 4), MR angiography (<i>n</i> = 3), and 18F-FDG PET/CT (<i>n</i> = 47). Overall and recurrence-free survival rates were analyzed using survival tables and Kaplan–Meier method.</p><p><b>.</b> The most frequent first manifestations of GCA were headache (81.8%), weakness (64%), fever (63.8%), and symptoms of rheumatic polymyalgia (56.6%). Changes in temporal arteries in color duplex scanning were detected in 44 out of 61 patients. GCs therapy was performed in all patients who agreed to be treated (<i>n</i> = 158), methotrexate was used in 49 out of 158 patients, leflunomide in 9 patients. In 45 (28.5%) out of 158 patients, a stable remission was achieved as a result of GC monotherapy; in 120 (75.9%) patients, long-term maintenance therapy with GCs was required to prevent exacerbations, including 71 (44.9%) patients in combination with methotrexate or other immunosuppressive drugs. The follow-up period of patients with a history of relapses was 21.0 (8.0–54.0) months. Relapses developed in 73 (46.2%) patients. The overall one-year survival rate was 97.1% [95% CI 94.3; 99.9], and the five-year survival rate of patients was 94.6% [95% CI 90.2; 99.0]. The one-year relapse-free survival rate was 86.4% [95% CI 80.5; 92.3], and the five-year relapse-free survival rate was 52.4% [95% CI 42.0; 62.8]. Twelve (7.2%) of 166 patients died. The cause of death was myocardial infarction in two patients, stroke in two patients, and breast cancer in one patient; in the remaining seven cases, the cause of death was not determined.</p><p>Given the high frequency of disease exacerbation, patients with GCA require long-term follow-up, especially during the first year after diagnosis.</p>","PeriodicalId":529,"journal":{"name":"Doklady Biochemistry and Biophysics","volume":"517 1","pages":"250 - 258"},"PeriodicalIF":0.8000,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical Manifestations and Prognosis of Giant Cell Arteritis: A Retrospective Cohort Study\",\"authors\":\"E. E. Fedorinova, N. M. Bulanov, A. D. Meshkov, O. O. Borodin, I. O. Smitienko, E. V. Chachilo, A. A. Nartov, A. L. Filatova, A. V. Naumov, P. I. Novikov, S. V. Moiseev\",\"doi\":\"10.1134/S1607672924700984\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>The aim of the study was to evaluate the clinical manifestations and survival of patients with giant cell arteritis (GCA).</p><p><b>.</b> A retrospective study included 166 patients with newly diagnosed GCA. Clinical, laboratory, and instrumental data and three sets of classification criteria were used to confirm the diagnosis: the American College of Rheumatology (ACR) 1990, the revised ACR criteria of 2016 and/or the new ACR and European Alliance of Rheumatologic Associations (EULAR) 2022 criteria. Some of the patients underwent instrumental investigations: temporal artery ultrasound Doppler (<i>n</i> = 61), contrast-enhanced computed tomography (<i>n</i> = 5), CT angiography (<i>n</i> = 6), magnetic resonance imaging (<i>n</i> = 4), MR angiography (<i>n</i> = 3), and 18F-FDG PET/CT (<i>n</i> = 47). Overall and recurrence-free survival rates were analyzed using survival tables and Kaplan–Meier method.</p><p><b>.</b> The most frequent first manifestations of GCA were headache (81.8%), weakness (64%), fever (63.8%), and symptoms of rheumatic polymyalgia (56.6%). Changes in temporal arteries in color duplex scanning were detected in 44 out of 61 patients. GCs therapy was performed in all patients who agreed to be treated (<i>n</i> = 158), methotrexate was used in 49 out of 158 patients, leflunomide in 9 patients. In 45 (28.5%) out of 158 patients, a stable remission was achieved as a result of GC monotherapy; in 120 (75.9%) patients, long-term maintenance therapy with GCs was required to prevent exacerbations, including 71 (44.9%) patients in combination with methotrexate or other immunosuppressive drugs. The follow-up period of patients with a history of relapses was 21.0 (8.0–54.0) months. Relapses developed in 73 (46.2%) patients. The overall one-year survival rate was 97.1% [95% CI 94.3; 99.9], and the five-year survival rate of patients was 94.6% [95% CI 90.2; 99.0]. The one-year relapse-free survival rate was 86.4% [95% CI 80.5; 92.3], and the five-year relapse-free survival rate was 52.4% [95% CI 42.0; 62.8]. Twelve (7.2%) of 166 patients died. 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Clinical Manifestations and Prognosis of Giant Cell Arteritis: A Retrospective Cohort Study
The aim of the study was to evaluate the clinical manifestations and survival of patients with giant cell arteritis (GCA).
. A retrospective study included 166 patients with newly diagnosed GCA. Clinical, laboratory, and instrumental data and three sets of classification criteria were used to confirm the diagnosis: the American College of Rheumatology (ACR) 1990, the revised ACR criteria of 2016 and/or the new ACR and European Alliance of Rheumatologic Associations (EULAR) 2022 criteria. Some of the patients underwent instrumental investigations: temporal artery ultrasound Doppler (n = 61), contrast-enhanced computed tomography (n = 5), CT angiography (n = 6), magnetic resonance imaging (n = 4), MR angiography (n = 3), and 18F-FDG PET/CT (n = 47). Overall and recurrence-free survival rates were analyzed using survival tables and Kaplan–Meier method.
. The most frequent first manifestations of GCA were headache (81.8%), weakness (64%), fever (63.8%), and symptoms of rheumatic polymyalgia (56.6%). Changes in temporal arteries in color duplex scanning were detected in 44 out of 61 patients. GCs therapy was performed in all patients who agreed to be treated (n = 158), methotrexate was used in 49 out of 158 patients, leflunomide in 9 patients. In 45 (28.5%) out of 158 patients, a stable remission was achieved as a result of GC monotherapy; in 120 (75.9%) patients, long-term maintenance therapy with GCs was required to prevent exacerbations, including 71 (44.9%) patients in combination with methotrexate or other immunosuppressive drugs. The follow-up period of patients with a history of relapses was 21.0 (8.0–54.0) months. Relapses developed in 73 (46.2%) patients. The overall one-year survival rate was 97.1% [95% CI 94.3; 99.9], and the five-year survival rate of patients was 94.6% [95% CI 90.2; 99.0]. The one-year relapse-free survival rate was 86.4% [95% CI 80.5; 92.3], and the five-year relapse-free survival rate was 52.4% [95% CI 42.0; 62.8]. Twelve (7.2%) of 166 patients died. The cause of death was myocardial infarction in two patients, stroke in two patients, and breast cancer in one patient; in the remaining seven cases, the cause of death was not determined.
Given the high frequency of disease exacerbation, patients with GCA require long-term follow-up, especially during the first year after diagnosis.
期刊介绍：
Doklady Biochemistry and Biophysics is a journal consisting of English translations of articles published in Russian in biochemistry and biophysics sections of the Russian-language journal Doklady Akademii Nauk. The journal''s goal is to publish the most significant new research in biochemistry and biophysics carried out in Russia today or in collaboration with Russian authors. The journal accepts only articles in the Russian language that are submitted or recommended by acting Russian or foreign members of the Russian Academy of Sciences. The journal does not accept direct submissions in English.
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