巨细胞动脉炎(GCA)患者对西利珠单抗反应的预测性生物标志物:与成像活动的相关性。

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
ACS Applied Electronic Materials Pub Date : 2024-10-01 Epub Date: 2024-08-30 DOI:10.1007/s12026-024-09518-0
Maurizio Benucci, Ilaria Di Girolamo, Antonino Di Girolamo, Francesca Li Gobbi, Arianna Damiani, Serena Guiducci, Barbara Lari, Valentina Grossi, Maria Infantino, Mariangela Manfredi
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引用次数: 0

摘要

根据EULAR最近的建议,超声检查现在被推荐为所有疑似巨细胞动脉炎(GCA)患者的一线影像学检查,腋动脉也应纳入标准检查范围。作为超声评估的替代方法,颅内和颅外动脉可通过 FDG-PET 或核磁共振成像进行检查。我们的研究旨在通过回顾性病例系列观察在接受泼尼松(PDN)和妥西珠单抗(TCZ)治疗的 GCA 患者中,生物标志物与成像活动之间是否存在相关性。我们回顾性地纳入了在 2020 年 1 月至 2021 年 9 月期间新确诊的 68 名 GCA 患者,这些患者在意大利佛罗伦萨圣乔瓦尼迪奥医院风湿科接受了实际随访。患者在T0-T3-T6-T12-T18-T24期间接受了以下血液化验评估:血沉、CRP、纤维蛋白原、血小板计数、血清淀粉样蛋白 A(SAA)、IL-6 和循环钙蛋白(MRP)。在开始使用大剂量糖皮质激素治疗 7 天内的 T0 期,以及随后的 T3-T6-T12-T18-T24 期,对颞动脉和腋动脉进行超声检查。在 T0-T12-T24 期 间,使用半定量工具(最大 SUV 值)对 0 至 3 级进行评估。对实验室和成像变量之间相关系数的评估显示,SAA 和 MRP 与 PET 评分的相关性最强(分别为 0.523 和 0.64),MRP 与 Halo 评分的相关系数也很高(0.658)。ROC 曲线的评估结果显示,PET 评分 3 和 SAA 值高于 26 mg/L 时,灵敏度为 81.5%,特异度为 84.1%;PET 评分 3 和 MRP 值高于 2.3 mcg/mL 时,灵敏度为 100%,特异度为 76.8%。本研究表明,SAA 和 MRP 是检测 GCA 活动的有效工具。研究表明,这两种生物标志物与通过 Halo 和 PET 评分评估的成像活动之间存在良好的相关性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Predictive biomarkers of response to tocilizumab in giant cell arteritis (GCA): correlations with imaging activity.

Predictive biomarkers of response to tocilizumab in giant cell arteritis (GCA): correlations with imaging activity.

In the recent EULAR recommendations, ultrasound examination is now recommended as a first-line imaging test in all patients with suspected giant cell arteritis (GCA) and the axillary arteries should be included in the standard exam. As an alternative to ultrasound evaluation, cranial and extracranial arteries can be examined using FDG-PET or MRI. The aim of our study was to observe in a retrospective case series whether there is a correlation between biomarkers and imaging activity in a population of patients followed in real life with GCA treated with prednisone (PDN) and tocilizumab (TCZ). We retrospectively enrolled 68 patients with newly diagnosed GCA between January 2020 and September 2021, followed in real life, who were examined at the Rheumatology Unit of the San Giovanni di Dio Hospital, Florence, Italy. Patients were evaluated at T0-T3-T6-T12-T18-T24 for the following blood tests: ESR, CRP, fibrinogen, platelet count, serum amyloid A (SAA), IL-6, and circulating calprotectin (MRP). Ultrasound examination of the temporal arteries and axillary arteries was assessed at T0 within 7 days of starting treatment with high-dose glucocorticoids and subsequently at T3-T6-T12-T18-T24. A scale from 0 to 3 with semi-quantitative tools (SUV max) was assessed at T0-T12-T24. The evaluation of the correlation coefficient between laboratory and imaging variables has shown that SAA and MRP have the most powerful correlation with the PET score (0.523 and 0.64), and MRP also has an excellent correlation coefficient with the Halo score (0.658). The evaluation of the ROC curves shows for a PET score 3 and SAA values higher than 26 mg/L, sensitivity of 81.5% and specificity of 84.1%, and for a PET score 3 and MRP values higher than 2.3 mcg/mL, sensitivity of 100% and specificity of 76.8%. In this study, we demonstrated that SAA and MRP can be useful as promising tools to detect GCA activity. The study demonstrates a good correlation between the two biomarkers and the imaging activity evaluated by the Halo and PET scores.

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