Vasculitis & polymyalgia rheumatica

Fibroblast activation protein inhibitor-positron emission tomography in aortitis: fibroblast pathology in active inflammation and remission

Rheumatology (Oxford)Published Exploratory pilot study

Authors' conclusion

This pilot feasibility study shows significant tracer uptake in the aortic walls in LVV. FAPI positivity indicates ongoing fibroblast pathology in clinically remitted LVV.

Study context

Population
Large vessel vasculitis (LVV) patients with aortitis (3 clinically active, 5 in remission) and age- and gender-matched controls
Participants
8 vs 8
Comparison
LVV with aortitis vs age- and gender-matched controls
  • Aortitisn = 8
  • Controlsn = 8reference
Outcome
Fibroblast activation in vessel walls detected by FAPI-PET/CT
Methodological detailsage- and gender-matched controls, FAPI-PET/CT
  • Age- and gender-matched controls
  • FAPI-PET/CT

Main finding

As reported in the abstract

  • Irrespective of activity, FAPI uptake significantly enhanced in aortitis vs controls

Further findings

Remitted aortitis: visually identifiable FAPI uptake
4/5 · events

Remitted aortitis: visually identifiable FAPI uptake

Significant FAPI uptake in vessel wall despite mean remission duration of 2.8 years (range 1-4 years)
MRI inflammatory scores close to negative in remitted aortitis

Original publication

Fibroblast activation protein inhibitor-positron emission tomography in aortitis: fibroblast pathology in active inflammation and remission. Rheumatology (Oxford). Published 22 April 2024. doi:10.1093/rheumatology/keae225

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