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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
Published on: February 8, 2019
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Evaluation of damage in giant cell arteritis
Tanaz A Kermani1, Antoine G Sreih2, David Cuthbertson3
1Division of Rheumatology, University of California Los Angeles, Los Angeles, CA.
Rheumatology (Oxford, England)
|November 8, 2017
Summary
Giant cell arteritis (GCA) causes significant damage, particularly to large arteries and eyes. While disease duration increases damage risk, early diagnosis and managing relapses may mitigate this burden.
Area of Science:
- Rheumatology
- Vasculitis Research
- Longitudinal Patient Studies
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting large arteries.
- Understanding the cumulative damage and associated factors in GCA is crucial for patient management.
- Previous studies have highlighted various complications, but a comprehensive analysis of damage progression is needed.
Purpose of the Study:
- To evaluate the extent of damage and identify variables associated with damage accrual in patients with GCA.
- To differentiate between disease-related and treatment-related damage in GCA.
- To assess the impact of disease duration and relapses on damage development.
Main Methods:
- Prospective, multicentre, longitudinal study design.
- Inclusion of 204 patients diagnosed with GCA.
- Assessment of damage using the Vasculitis Damage Index and the Large-Vessel Vasculitis Index of Damage at baseline and follow-up.
Main Results:
- High prevalence of damage at baseline (54-60%) and last follow-up (79-82%) using both indices.
- Most frequent damage items included large-artery complications (29%) and ocular manifestations (22%).
- New damage primarily involved ocular, cardiac/vascular, and musculoskeletal systems; treatment-associated damage (cataracts, osteoporosis) was common.
- Disease duration increased damage risk (OR 1.22 per year); early diagnosis (within 90 days) and fewer relapses reduced new damage risk.
Conclusions:
- Large-artery complications and ocular manifestations are the predominant forms of damage in GCA.
- A significant proportion of new damage in GCA is attributable to treatment side effects.
- These findings underscore the substantial cumulative burden of GCA, emphasizing the need for optimized treatment strategies to minimize long-term damage.
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