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. 2015 Mar-Apr;33(2 Suppl 89):S-98-102.
Epub 2015 May 26.

Glucocorticoid usage in giant cell arteritis over six decades (1950 to 2009)

A Chandran  1 , Pr D Udayakumar  2 , T A Kermani  3 , K J Warrington  1 , C S Crowson  4 , E L Matteson  5
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Glucocorticoid usage in giant cell arteritis over six decades (1950 to 2009)

A Chandran et al. Clin Exp Rheumatol. 2015 Mar-Apr.

Abstract

Objectives: To evaluate the trends in glucocorticoid (GC) therapy in patients with giant cell arteritis (GCA).

Methods: Using a population-based inception cohort, GC therapy details were collected for all patients with GCA diagnosed between 1950-2009. GC usage for patients diagnosed with GCA between 1980-2009 was compared to those diagnosed between 1950-1979.

Results: The mean starting dose was similar in both time-periods but the mean cumulative dosages at different time points were significantly higher for patients diagnosed between 1980-2009 than in 1950-1979 (at 1-year: 6.3 vs. 4.1g; and at 5 years 10.7 vs. 7.6g, respectively, p<0.001). The median time to permanent discontinuation of GC was 2.6 years for 1980-2009 vs. 1.5 years for 1950-1979 (p=0.004). The risk for GC-associated adverse events was similar in both time periods (p=0.52).

Conclusions: GCA patients diagnosed in the last three decades were treated with higher cumulative GC doses and were less likely to achieve GC discontinuation. However, their risks for GC-related complications were not significantly higher than their earlier counterparts.

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Figures

Figure 1
Figure 1
Median initial dose, and cumulative dose of glucocorticoid (prednisone equivalent) at the end of 1, 2 and 5 years of treatment in patient with giant cell arteritis over 6 decades
Figure 2
Figure 2
Rates of glucocorticoid dosage discontinuation for 242 patients with giant cell arteritis throughout disease duration
See this image and copyright information in PMC

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