PMID- 33831144
OWN - NLM
STAT- MEDLINE
DCOM- 20210823
LR  - 20210823
IS  - 1462-0332 (Electronic)
IS  - 1462-0324 (Linking)
VI  - 60
IP  - 8
DP  - 2021 Aug 2
TI  - Resolution of vascular inflammation in patients with new-onset giant cell 
      arteritis: data from the RIGA study.
PG  - 3851-3861
LID - 10.1093/rheumatology/keab332 [doi]
AB  - OBJECTIVES: Efficacy evaluation of GCA treatment is primarily based on 
      non-specific symptoms and laboratory markers. We aimed to assess the change in 
      vascular inflammation in patients with large vessel (LV)-GCA under different 
      treatments using [18F]FDG PET/CT. METHODS: Observational study on patients with 
      new-onset, active LV-GCA starting treatment with either prednisolone monotherapy 
      (PRED) or combination with MTX or tocilizumab (TOC). All patients underwent 
      baseline and follow-up PET/CT. The aorta and its major branches were assessed 
      using PET vascular activity score (PETVAS) by independent readers. Cumulative 
      glucocorticoid doses and cessation of glucocorticoid treatment were documented in 
      all patients. RESULTS: We included 88 LV-GCA patients, 27 were treated with PRED, 
      42 with MTX and 19 with TOC. PETVAS decreased from 18.9-8.0 units at follow-up in 
      the overall population (P <0.001). PETVAS changes were numerically higher in 
      patients receiving MTX (-12.3 units) or TOC (-11.7 units) compared with PRED 
      (-8.7). Mean cumulative prednisolone dosages were 5637, 4418 and 2984 mg in 
      patients treated with PRED, MTX and TOC (P =0.002). Risk ratios for 
      glucocorticoid discontinuation at the time of follow-up PET/CT were 6.77 (95% CI: 
      1.01, 45.29; P =0.049) and 16.25 (95% CI: 2.60, 101.73; P =0.003) for MTX and TOC 
      users compared with PRED users. CONCLUSION: Treatment of LV-GCA inhibits vascular 
      inflammation in the aorta and its major branches. While similar control of 
      vascular inflammation was achieved with PRED, MTX and TOC treatments, TOC showed 
      a strong glucocorticoid sparing effect, supporting the concept of initial 
      combination therapy.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of the 
      British Society for Rheumatology. All rights reserved. For permissions, please 
      email: journals.permissions@oup.com.
FAU - Schonau, Verena
AU  - Schonau V
AD  - Department of Internal Medicine 3, Friedrich-Alexander University (FAU) 
      Erlangen-Nuremberg and Universitatsklinikum Erlangen, Erlangen, Germany.
AD  - Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) 
      Erlangen-Nuremberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Roth, Jessica
AU  - Roth J
AD  - Department of Internal Medicine 3, Friedrich-Alexander University (FAU) 
      Erlangen-Nuremberg and Universitatsklinikum Erlangen, Erlangen, Germany.
AD  - Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) 
      Erlangen-Nuremberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Tascilar, Koray
AU  - Tascilar K
AD  - Department of Internal Medicine 3, Friedrich-Alexander University (FAU) 
      Erlangen-Nuremberg and Universitatsklinikum Erlangen, Erlangen, Germany.
AD  - Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) 
      Erlangen-Nuremberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Corte, Giulia
AU  - Corte G
AD  - Department of Internal Medicine 3, Friedrich-Alexander University (FAU) 
      Erlangen-Nuremberg and Universitatsklinikum Erlangen, Erlangen, Germany.
AD  - Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) 
      Erlangen-Nuremberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Manger, Bernhard
AU  - Manger B
AD  - Department of Internal Medicine 3, Friedrich-Alexander University (FAU) 
      Erlangen-Nuremberg and Universitatsklinikum Erlangen, Erlangen, Germany.
AD  - Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) 
      Erlangen-Nuremberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Rech, Juergen
AU  - Rech J
AD  - Department of Internal Medicine 3, Friedrich-Alexander University (FAU) 
      Erlangen-Nuremberg and Universitatsklinikum Erlangen, Erlangen, Germany.
AD  - Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) 
      Erlangen-Nuremberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Schmidt, Daniela
AU  - Schmidt D
AD  - Institute for Nuclear Medicine, Friedrich-Alexander University (FAU) 
      Erlangen-Nuremberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Cavallaro, Alexander
AU  - Cavallaro A
AD  - Institute of Radiology, Friedrich-Alexander University (FAU) Erlangen-Nuremberg 
      and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Uder, Michael
AU  - Uder M
AD  - Institute of Radiology, Friedrich-Alexander University (FAU) Erlangen-Nuremberg 
      and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Crescentini, Filippo
AU  - Crescentini F
AD  - Rheumatology Unit, Azienda Unita Sanitaria Locale-IRCCS di Reggio Emilia, Reggio 
      Emilia, Italy.
FAU - Boiardi, Luigi
AU  - Boiardi L
AD  - Rheumatology Unit, Azienda Unita Sanitaria Locale-IRCCS di Reggio Emilia, Reggio 
      Emilia, Italy.
FAU - Casali, Massimiliano
AU  - Casali M
AD  - Nuclear Medicine Unit, Azienda Unita Sanitaria Locale-IRCCS di Reggio Emilia, 
      Reggio Emilia, Italy.
FAU - Spaggiari, Lucia
AU  - Spaggiari L
AD  - Radiology Unit, Azienda Unita Sanitaria Locale-IRCCS di Reggio Emilia, Reggio 
      Emilia, Italy.
FAU - Galli, Elena
AU  - Galli E
AD  - Rheumatology Unit, Azienda Unita Sanitaria Locale-IRCCS di Reggio Emilia, Reggio 
      Emilia, Italy.
AD  - Department of Surgery, Medicine, Dentistry and Morphological Sciences with 
      interest in Transplant, Oncology and Regenerative Medicine, Universita di Modena 
      e Reggio Emilia, Modena, Italy.
FAU - Kuwert, Torsten
AU  - Kuwert T
AD  - Institute for Nuclear Medicine, Friedrich-Alexander University (FAU) 
      Erlangen-Nuremberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Versari, Annibale
AU  - Versari A
AD  - Nuclear Medicine Unit, Azienda Unita Sanitaria Locale-IRCCS di Reggio Emilia, 
      Reggio Emilia, Italy.
FAU - Salvarani, Carlo
AU  - Salvarani C
AD  - Rheumatology Unit, Azienda Unita Sanitaria Locale-IRCCS di Reggio Emilia, Reggio 
      Emilia, Italy.
AD  - Department of Surgery, Medicine, Dentistry and Morphological Sciences with 
      interest in Transplant, Oncology and Regenerative Medicine, Universita di Modena 
      e Reggio Emilia, Modena, Italy.
FAU - Schett, Georg
AU  - Schett G
AD  - Department of Internal Medicine 3, Friedrich-Alexander University (FAU) 
      Erlangen-Nuremberg and Universitatsklinikum Erlangen, Erlangen, Germany.
AD  - Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) 
      Erlangen-Nuremberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Muratore, Francesco
AU  - Muratore F
AD  - Rheumatology Unit, Azienda Unita Sanitaria Locale-IRCCS di Reggio Emilia, Reggio 
      Emilia, Italy.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - Rheumatology (Oxford)
JT  - Rheumatology (Oxford, England)
JID - 100883501
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Glucocorticoids)
RN  - 9PHQ9Y1OLM (Prednisolone)
RN  - I031V2H011 (tocilizumab)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
CIN - Rheumatology (Oxford). 2021 Aug 2;60(8):3494-3495. PMID: 33909889
MH  - Aged
MH  - Aged, 80 and over
MH  - Antibodies, Monoclonal, Humanized/therapeutic use
MH  - Antirheumatic Agents/*therapeutic use
MH  - Female
MH  - Giant Cell Arteritis/diagnostic imaging/*drug therapy
MH  - Glucocorticoids/*therapeutic use
MH  - Humans
MH  - Inflammation/diagnostic imaging
MH  - Male
MH  - Methotrexate/therapeutic use
MH  - Middle Aged
MH  - Positron Emission Tomography Computed Tomography
MH  - Prednisolone/therapeutic use
MH  - Treatment Outcome
OTO - NOTNLM
OT  - 18F-fluorodeoxyglucose positron emission tomography/computed tomography
OT  - giant cell arteritis
OT  - glucocorticoids
OT  - large vessel vasculitis
OT  - methotrexate
OT  - tocilizumab
OT  - treatment
EDAT- 2021/04/09 06:00
MHDA- 2021/08/24 06:00
CRDT- 2021/04/08 17:31
PHST- 2021/02/08 00:00 [received]
PHST- 2021/03/30 00:00 [revised]
PHST- 2021/04/09 06:00 [pubmed]
PHST- 2021/08/24 06:00 [medline]
PHST- 2021/04/08 17:31 [entrez]
AID - 6217850 [pii]
AID - 10.1093/rheumatology/keab332 [doi]
PST - ppublish
SO  - Rheumatology (Oxford). 2021 Aug 2;60(8):3851-3861. doi: 
      10.1093/rheumatology/keab332.