カツマタ　ヤスヒロ   勝又　康弘    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Associated factors of poor treatment outcomes in patients with giant cell arteritis: clinical implication of large vessel lesions.
掲載誌名	正式名：Arthritis research & therapy 略　 称：Arthritis Res Ther ISSNコード：14786362/14786354
掲載区分	国外
巻・号・頁	22(1),pp.72
著者・共著者	Sugihara Takahiko, Hasegawa Hitoshi, Uchida Haruhito A, Yoshifuji Hajime, Watanabe Yoshiko, Amiya Eisuke, Maejima Yasuhiro, Konishi Masanori, Murakawa Yohko, Ogawa Noriyoshi, Furuta Shunsuke, Katsumata Yasuhiro, Komagata Yoshinori, Naniwa Taio, Okazaki Takahiro, Tanaka Yoshiya, Takeuchi Tsutomu, Nakaoka Yoshikazu, Arimura Yoshihiro, Harigai Masayoshi, Isobe Mitsuaki,
発行年月	2020/04
概要	BACKGROUND:Relapses frequently occur in giant cell arteritis (GCA), and long-term glucocorticoid therapy is required. The identification of associated factors with poor treatment outcomes is important to decide the treatment algorithm of GCA.METHODS:We enrolled 139 newly diagnosed GCA patients treated with glucocorticoids between 2007 and 2014 in a retrospective, multi-center registry. Patients were diagnosed with temporal artery biopsy, 1990 American College of Rheumatology classification criteria, or large vessel lesions (LVLs) detected by imaging based on the modified classification criteria. Poor treatment outcomes (non-achievement of clinical remission by week 24 or relapse during 52 weeks) were evaluated. Clinical remission was defined as the absence of clinical signs and symptoms in cranial and large vessel areas, polymyalgia rheumatica (PMR), and elevation of C-reactive protein (CRP) levels. A patient was determined to have a relapse if he/she had either one of the signs and symptoms that newly appeared or worsened after achieving clinical remission. Re-elevation of CRP without clinical manifestations was considered as a relapse if other causes such as infection were excluded and the treatment was intensified. Associated factors with poor treatment outcomes were analyzed by using the Cox proportional hazard model.RESULTS:Cranial lesions, PMR, and LVLs were detected in 77.7%, 41.7%, and 52.5% of the enrolled patients, respectively. Treatment outcomes were evaluated in 119 newly diagnosed patients who were observed for 24 weeks or longer. The mean initial dose of prednisolone was 0.76 mg/kg/day, and 29.4% received any concomitant immunosuppressive drugs at baseline. Overall, 41 (34.5%) of the 119 patients had poor treatment outcomes; 13 did not achieve clinical remission by week 24, and 28 had a relapse after achieving clinical remission.
DOI	10.1186/s13075-020-02171-6
PMID	32264967