Association between the patterns of large-vessel lesions and treatment outcomes in patients with large-vessel giant cell arteritis
Association between the patterns of large-vessel lesions and treatment outcomes in patients with large-vessel giant cell arteritis
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大血管巨细胞动脉炎患者大血管病变模式与治疗结果之间的关联
DOI：
10.1093/mr/roac122
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发表时间：
2022
影响因子：
2.2
通讯作者：
Komagata Yoshi
中科院分区：
文献类型：
--
作者：
Sugihara Takahiko;Uchida Haruhito A;Yoshifuji Hajime;Maejima Yasuhiro;Naniwa Taio;Katsumata Yasuhiro;Okazaki Takahiro;Ishizaki Jun;Murakawa Yohko;Ogawa Noriyoshi;Dobashi Hiroaki;Horita Tetsuya;Tanaka Yoshiya;Furuta Shunsuke;Takeuchi Tsutomu;Komagata Yoshi
ObjectivesWe aimed to identify associations between patterns of large vessel giant cell arteritis（LV-GCA）and treatment outcomes.MethodsWe extracted data on 68 newly diagnosed patients with LV-GCA from a retrospective，multi-centric，national registry of GCA patients treated with glucocorticoids between 2007 and 2014.根据对比增强计算机断层扫描、磁共振成像或正电子发射断层扫描-计算机断层扫描的结果确定主动脉病变患者（第2组，n= 49）。无主动脉病变的患者被细分为LV-GCA伴或不伴锁骨下病变，分别定义为第1组（n= 9）或第3组（n= 10）。主要结局评价是未能达到临床缓解的第24周和/或复发104 weeks.ResultsThe平均年龄和比例的患者与颅病变和风湿性多肌痛组2在数值上低于其他两组。第3组的大血管病变包括颈动脉、肺、肾、肝或肠系膜病变。第1、2和3组中>2年不良治疗结局的累积发生率分别为11.1%、55.3%和88.0%（Kaplan-Meier分析）。两组之间达到不良结局的平均时间存在显着差异。结论锁骨下动脉和主动脉病变的分类可能有助于确定治疗策略。
ObjectivesWe aimed to identify associations between patterns of large-vessel lesions of large-vessel giant cell arteritis (LV-GCA) and treatment outcomes.MethodsWe extracted data on 68 newly diagnosed patients with LV-GCA from a retrospective, multi-centric, nationwide registry of GCA patients treated with glucocorticoids between 2007 and 2014. Patients with aortic lesions were identified based on the findings from contrast-enhanced computed tomography, magnetic resonance imaging, or positron emission tomography–computed tomography (Group 2,n= 49). Patients without aortic lesions were subdivided into LV-GCA with or without subclavian lesions defined as Group 1 (n= 9) or Group 3 (n= 10), respectively. The primary outcome evaluation was failure to achieve clinical remission by Week 24 and/or relapse within 104 weeks.ResultsThe mean age and proportion of patients with cranial lesions and polymyalgia rheumatica in Group 2 were numerically lower than in the other two groups. Large-vessel lesions in Group 3 included carotid, pulmonary, renal, hepatic, or mesenteric lesions. The cumulative rate of poor treatment outcomes >2 years was 11.1%, 55.3%, and 88.0% in Groups 1, 2, and 3, respectively (by Kaplan–Meier analysis). The mean time to poor outcome was significantly different between the groups.ConclusionsClassification by subclavian and aortic lesions may be useful to determine treatment strategy.