Vasculitis & polymyalgia rheumatica
Biomarker trajectories and risk of relapse in giant cell arteritis: a multicenter study
Authors' conclusion
In our GCA cohort, relapse risk was associated with cranial manifestations and aortic uptake on PET-CT at diagnosis. PF normalization at 1 month was identified as an early marker of a lower relapse risk, although this biomarker requires external validation. CRP and PF trajectories identified distinct phenotypes associated with different relapse risks, supporting further evaluation of longitudinal biomarker-guided follow-up.
Study context
- Population
- Patients diagnosed with giant cell arteritis (GCA) between 2000 and 2023 fulfilling GiACTA inclusion criteriapatients diagnosed with GCA, CRP and plasma fibrinogen (PF) collected until relapse or up to 2 years in a subset diagnosed from 2017 to 2022 · Subset diagnosed from 2017 to 2022 with longitudinal CRP and PF 135
- Participants
- 465 patients
- Exposure
- Associations between biomarker dynamics and relapse
- Outcome
- ≥ 1 relapse
- Follow-up
- Within 5 years
Methodological detailsjoint modeling
- Joint modeling
Main finding
As reported in the abstract
Patients with ≥ 1 relapse
34.2%
Observational data: associations, not effects.
Further findings
Relapse, by PF normalization at 1 month · over 2 years
| HR (95% CI) | P value | ||
|---|---|---|---|
| PF normalization at 1 month | 0.14 (0.07–0.28) | P < 0.001 | |
| 0.050.21520Hazard ratio (log scale) |
- Relapse, by PF normalization at 1 month: lower relapse risk with PF normalization at 1 month; comparator not stated
Baseline characteristics associated with relapse · At diagnosis
- Headache, jaw claudication and aortic FDG uptake on PET-CT were associated with higher relapse risk
Discrimination of PF at month 1 for relapse
- AUC
- 0.82 (bootstrap 95% CI 0.69-0.91)
- Exploratory ROC-derived cut-off
- 3.77 g/L (bootstrap 95%CI, 3.45-3.97)
- Sensitivity at cut-off
- 71.8%
- Specificity at cut-off
- 90.0%
Individual trajectories of CRP and PF
- Trajectories were heterogeneous and identified distinct phenotypes associated with different relapse risks
Original publication
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