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Rev Med Interne ; 45(6): 335-342, 2024 Jun.
Artículo en Francés | MEDLINE | ID: mdl-38216390

RESUMEN

INTRODUCTION: The management of giant cell arteritis (GCA) has evolved with the arrival of tocilizumab (TCZ) and the use of PET/CT. Our objective is to describe the characteristics and followup of patients with recent diagnosis of GCA in current care. PATIENTS AND METHODS: The NEWTON cohort is a monocentric retrospective cohort based on data collected from 60 GCA patients diagnosed between 2017 and 2022 according to the ACR/EULAR 2022 criteria. RESULTS: The median age at diagnosis was 73 [68.75; 81] years old. At diagnosis, the main manifestations were unusual temporal headaches in 48 (80 %) and an inflammatory syndrome in 50 (83 %) patients. Temporal artery biopsy confirmed the diagnosis in 49/58 (84 %) patients. Doppler of the temporal arteries found a halo in 12/23 (52 %) patients. The PET/CT found hypermetabolism in 19/43 (44 %) patients. Prednisone was stopped in 17.5 [12.75; 24.25] months. During follow-up, 22 (37 %) patients received TCZ. At least one complication of corticosteroid therapy was observed in 22 (37 %) patients. After a median follow-up of 24 [12; 42] months, 25 (42 %) patients relapsed. At the end of the follow-up, 29 (48.3 %) patients were weaned from corticosteroid therapy and 15 (25 %) were on TCZ. CONCLUSION: Despite the increasing use of TCZ in the therapeutic arsenal and of the PET/CT in the imaging tools of GCA patients, relapses and complications of corticosteroid therapy remain frequent, observed in more than a third of patients.


Asunto(s)
Arteritis de Células Gigantes , Tomografía Computarizada por Tomografía de Emisión de Positrones , Humanos , Arteritis de Células Gigantes/diagnóstico , Arteritis de Células Gigantes/epidemiología , Arteritis de Células Gigantes/complicaciones , Femenino , Anciano , Masculino , Estudios Retrospectivos , Estudios de Seguimiento , Anciano de 80 o más Años , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Anticuerpos Monoclonales Humanizados/uso terapéutico , Estudios de Cohortes , Arterias Temporales/patología
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