Vasculitis & polymyalgia rheumatica
The giant cell arteritis (GCA) ultrasound score (OGUS) at diagnosis and after initial treatment predicts future relapses in GCA patients: results of a multicentre prospective study
Authors' conclusion
Ultrasonography has a prognostic role in GCA and can inform risk stratification. Higher OGUS at diagnosis is associated with relapse, while a higher degree and rapidity of improvement in the first weeks are linked with lower relapse rate.
Study context
- Population
- Patients with new onset GCA undergoing serial ultrasound assessment
- Participants
- 97 patients849 visits
- Outcome
- Relapse (recurrence of GCA-related symptoms or rise of inflammatory markers requiring treatment)
- Follow-up
- 12 months
Methodological detailsmulticentre, serial ultrasound assessment at fixed time points, multivariable Poisson model with robust variance estimator
- Multicentre
- Serial ultrasound assessment at fixed time points
- Multivariable Poisson model with robust variance estimator
Main finding
As reported in the abstract
IRR for each 1 point increase in OGUS at diagnosis
1.85
95% CI 1.05–3.32
Patients with relapse (36.1%); 66 relapses in total
35
Median time to relapse, days (IQR 94.5-323.5)
210
Observational data: associations, not effects.
Further findings
Subsequent relapses with OGUS normalisation (score <1) over first 3 weeks
- IRR (95% CI 0.22-0.88); also predicted time to first relapse
- 0.44
- Multivariable analysis
DMARD initiation · 12 weeks
- OGUS reduction over first 12 weeks inversely associated with initiation of disease-modifying antirheumatic drugs (DMARDs)
Safety
Ischaemic/aortic complications
- Rare
Original publication
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