Presentation and Real-World Management of Giant Cell Arteritis (Artemis Study)

Publication

Presentation and Real-World Management of Giant Cell Arteritis (Artemis Study)

Journal Paper/Review - Nov 11, 2021

Mahr Alfred, Jouvray Mathieu, Shipley Emilie, Tieulie Nathalie, Armengol Guillaume, Bouldoires Bastien, Viallard Jean-Francois, Idier Isabelle, Paccalin Marc, Djerad Mohamed, Zenone Thierry, Sailler Laurent, Hachulla Eric, de Boysson Hubert, Guerroui Nassim, Héron Emmanuel, Vinzio Stéphane, Broner Jonathan, Lapébie François-Xavier, Michaud Martin, Devauchelle-Pensec Valérie

Citation

Mahr A, Jouvray M, Shipley E, Tieulie N, Armengol G, Bouldoires B, Viallard J, Idier I, Paccalin M, Djerad M, Zenone T, Sailler L, Hachulla E, de Boysson H, Guerroui N, Héron E, Vinzio S, Broner J, Lapébie F, Michaud M, Devauchelle-Pensec V. Presentation and Real-World Management of Giant Cell Arteritis (Artemis Study). Front Med (Lausanne) 2021; 8:732934.

Type

Journal Paper/Review (English)

Journal

Front Med (Lausanne) 2021; 8

Publication Date

Nov 11, 2021

Issn Print

2296-858X

Pages

732934

Brief description/objective

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. 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. 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, FDG-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. 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.