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Updated: Jan 2, 2026
A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
Outcome Measures in Large Vessel Vasculitis: Relationship Between Patient-, Physician-, Imaging-, and
Casey A Rimland1, Kaitlin A Quinn2, Joel S Rosenblum3
1NIH, Bethesda, Maryland, and University of North Carolina at Chapel Hill School of Medicine, Chapel Hill.
Insights
Disease assessment in large vessel vasculitis involves multiple measures that are independently linked. Developing composite outcome measures is recommended to capture a comprehensive view of disease activity.
Area of Science:
- Rheumatology
- Immunology
- Internal Medicine
Background:
- Large vessel vasculitis (LVV) encompasses conditions like giant cell arteritis (GCA) and Takayasu arteritis (TAK).
- Accurate disease assessment is crucial for effective management and monitoring of LVV activity.
Purpose of the Study:
- To evaluate the relationships between various disease assessment measures in patients with LVV.
- To understand how patient-reported outcomes, physician assessments, laboratory markers, and imaging correlate in LVV.
Main Methods:
- A prospective, observational cohort study included 112 patients with GCA or TAK.
- Data collected included patient-reported outcomes (PROs), physician global assessment (PhGA), laboratory markers (CRP, ESR), and imaging (PETVAS).
- Correlation network analysis was used to assess relationships between different outcome measures.
Main Results:
- Disease assessment measures clustered by type, indicating independent assessment domains.
- Physician global assessment (PhGA) showed modest correlations with other measures.
- Patient-reported outcomes strongly correlated with each other, but had limited correlation with imaging (PETVAS).
- Changes in clinical assessment correlated with changes in ESR, CRP, and PETVAS.
Conclusions:
- Current disease assessment measures in LVV are independent yet complementary.
- There is a need to develop composite outcome measures or standardized sets of measures that integrate different assessment types.
- A multimodal approach is essential for a comprehensive understanding of disease activity in LVV.
Objective:
To assess the relationship between measures of disease assessment in patients with large vessel vasculitis.
Methods:
Patients with giant cell arteritis (GCA) or Takayasu arteritis (TAK) were recruited into a prospective, observational cohort. Assessments within the following outcomes were independently recorded: 1) patient-reported outcomes (Multidimensional Fatigue Inventory, patient global assessment of disease activity [PtGA], Short Form 36 health survey [SF-36], Brief Illness Perception Questionnaire), 2) physician global assessment of disease activity (PhGA), 3) laboratory outcomes (C-reactive protein [CRP] level, erythrocyte sedimentation rate [ESR]), and 4) imaging outcomes (PETVAS, a qualitative score of vascular 18 F-fluorodeoxyglucose-positron emission tomography activity).
Results:
Analyses were performed on 112 patients (GCA = 56, TAK = 56), over 296 visits, with a median follow-up of 6 months. Correlation network analysis revealed assessment measures clustered independently by type of outcome. PhGA was centrally linked to all other outcome types, but correlations were modest (ρ = 0.12-0.32; P < 0.05). PETVAS, CRP level, and PtGA were independently associated with clinically active disease. All 4 patient-reported outcomes strongly correlated with each other (ρ = 0.35-0.60; P < 0.0001). Patient-reported outcomes were not correlated with PETVAS, and only PtGA correlated with CRP level (ρ = 0.16; P < 0.01). Patients whose clinical assessment changed from active disease to remission (n = 29) had a corresponding significant decrease in ESR, CRP level, and PETVAS at the remission visit. Patients whose clinical assessment changed from remission to active disease (n = 11) had a corresponding significant increase in CRP level and PtGA at the active visit.
Conclusion:
Measures of disease assessment in large vessel vasculitis consist of independent, yet complementary, outcomes, supporting the need to develop composite outcome measures or a standard set of measures covering multiple types of outcomes.
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