Vasculitis & polymyalgia rheumatica
Complete metabolic remission on PET/CT following glucocorticoids monotherapy in giant cell arteritis-related large-vessel involvement
Authors' conclusion
A complete metabolic remission on PET/CT was observed in 43% of GCA patients with LVI treated with GC alone. Aortic dilation exclusively occurred in patients with persistent positive PET/CT.
Study context
- Population
- Giant cell arteritis (GCA) patients with large-vessel involvement (LVI) diagnosed on PET/CT, treated only with glucocorticoids (GC), with a second PET/CT >3 months after the first
- Participants
- 75 patients
- Exposure
- Complete metabolic remission vs Without metabolic remission
- Complete metabolic remissionn = 32
- Without metabolic remissionn = 43reference
- Outcome
- Proportion of patients with complete metabolic remission on the second PET/CT
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Patients with complete metabolic remission
32
43%
Observational data: associations, not effects.
Further findings
- GC discontinued at last follow-up · last follow-up (median: 51 [27-93] months) — Without metabolic remission
- 56%
- GC discontinued at last follow-up: With metabolic remission 66 %
Timing of second PET/CT after initial PET/CT
- Second PET/CT performed 8 [5-11] months after the initial PET/CT
GC weaning among the 32 patients with complete metabolic remission · follow-up >12 months after the negative PET/CT
- Weaned off GC with follow-up >12 months after the negative PET/CT (of 32)
- 16
PET/CT course among the 43 patients without metabolic remission
- Stable or increased vascular uptake
- 19
- Persistent PET/CT positivity with fewer involved vascular territories
- 24
LVI relapse on a third PET/CT
- Patients with LVI relapse on a third PET/CT
- 2
Aortic dilation during follow-up (34 patients with available aorta morphology data)
- Developed aortic dilation, all with persistent positive PET/CT
- 8
- Log-rank: P<0.05
Original publication
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