Glucocorticoid usage in giant cell arteritis over six decades (1950 to 2009)
Chandran, A.; Udayakumar, P.D.; Kermani, T.A.; Warrington, K.J.; Crowson, C.S.; Matteson, E.L.
Clinical and Experimental Rheumatology 33(2 Suppl 89: S
2015
ISSN/ISBN: 0392-856X PMID: 26016757 Document Number: 685036
To evaluate the trends in glucocorticoid (GC) therapy in patients with giant cell arteritis (GCA). Using a population-based inception cohort, GC therapy details were collected for all patients with GCA diagnosed between 1950-2009. GC usage for patients diagnosed with GCA between 1980-2009 was compared to those diagnosed between 1950-1979. The mean starting dose was similar in both time-periods but the mean cumulative dosages at different time points were significantly higher for patients diagnosed between 1980-2009 than in 1950-1979 (at 1-year: 6.3 vs. 4.1g; and at 5 years 10.7 vs. 7.6g, respectively, p<0.001). The median time to permanent discontinuation of GC was 2.6 years for 1980-2009 vs. 1.5 years for 1950-1979 (p=0.004). The risk for GC-associated adverse events was similar in both time periods (p=0.52). GCA patients diagnosed in the last three decades were treated with higher cumulative GC doses and were less likely to achieve GC discontinuation. However, their risks for GC-related complications were not significantly higher than their earlier counterparts.