Risk factors for visual loss in an Italian population-based cohort of patients with giant cell arteritis

2005 ◽  
Vol 53 (2) ◽  
pp. 293-297 ◽  
Author(s):  
Carlo Salvarani ◽  
Luca Cimino ◽  
Pierluigi Macchioni ◽  
Dario Consonni ◽  
Fabrizio Cantini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Visual Loss ◽  
Population Based ◽  
Italian Population

scholarly journals Risk factors for severe cranial ischaemic events in an Italian population-based cohort of patients with giant cell arteritis

Rheumatology ◽  
2008 ◽  
Vol 48 (3) ◽  
pp. 250-253 ◽  
Author(s):  
C. Salvarani ◽  
C. D. Bella ◽  
L. Cimino ◽  
P. Macchioni ◽  
D. Formisano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Population Based ◽  
Italian Population

–463 G/A myeloperoxidase promoter polymorphism in giant cell arteritis

2007 ◽  
Vol 67 (4) ◽  
pp. 485-488 ◽  
Author(s):  
C Salvarani ◽  
B Casali ◽  
E Farnetti ◽  
N Pipitone ◽  
D Nicoli ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Clinical Features ◽  
Polymyalgia Rheumatica ◽  
Visual Loss ◽  
Geographic Area ◽  
Population Based ◽  
Promoter Polymorphism ◽  
Reggio Emilia ◽  
Cerebrovascular Accidents

Objective:To investigate potential associations between–463 G/A myeloperoxidase (MPO) promoter polymorphism and susceptibility to, and clinical features of giant cell arteritis (GCA).Methods:A total of 156 patients with biopsy-proven GCA who were residents of Reggio Emilia, Italy, and 235 population-based controls from the same geographic area were genotyped for–463 G/A promoter polymorphism of the MPO gene by molecular methods. The patients were subgrouped according to the presence or absence of polymyalgia rheumatica and severe ischaemic complications (visual loss and/or cerebrovascular accidents).Results:The distribution of the MPO-G/A genotype differed significantly between patients with GCA and the controls (pcorr = 0.003). Allele G was significantly more frequent in patients with GCA than in the controls (pcorr = 0.0002, OR 2.0, 95% CI 1.4 to 2.9). Homozygosity for the G allele was significantly more frequent in patients with GCA than in controls (pcorr = 0.0002, OR 2.2, 95% CI 1.4 to 3.4). No significant associations were found when patients with GCA with and without polymyalgia rheumatica or with and without severe ischaemic complications were compared.Conclusions:Our findings show that the–463 G/A promoter polymorphism of the MPO gene is associated with GCA susceptibility and support a role for MPO in the pathophysiology of GCA.

SAT0365 Risk Factors for Visual Loss in Giant Cell Arteritis (GCA)

2016 ◽  
Vol 75 (Suppl 2) ◽  
pp. 799.1-799
Author(s):  
R. Solans-Laqué ◽  
G. Fraile ◽  
B. Escalante ◽  
E. Fonseca ◽  
A. Martinez-Zapico ◽  
...  
Keyword(s):  
Risk Factors ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Visual Loss

Risk Factors for Permanent Visual Loss in Biopsy-proven Giant Cell Arteritis: A Study of 339 Patients

2016 ◽  
Vol 43 (7) ◽  
pp. 1393-1399 ◽  
Author(s):  
Eric Liozon ◽  
François Dalmay ◽  
Fabrice Lalloue ◽  
Guillaume Gondran ◽  
Holy Bezanahary ◽  
...  
Keyword(s):  
Risk Factors ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Visual Loss ◽  
Clinical Findings ◽  
Multivariable Logistic Regression Analysis ◽  
Glucocorticoid Treatment ◽  
Increased Risk ◽  
History Of ◽  
Laboratory Variables

Objective.To determine the risk factors for permanent visual loss (PVL) in patients with biopsy-proven giant cell arteritis (GCA) and the usefulness of the factors in clinical practice.Methods.From 1976 through 2015, the clinical charts and laboratory results of 339 patients with biopsy-proven GCA were recorded prospectively at the time of diagnosis. We used multivariable logistic regression analysis to determine which of 24 pretreatment characteristics were associated with PVL.Results.Visual ischemic manifestations occurred in 108 patients, including PVL in 53 (16%), bilaterally in 15 patients (28%). The independent predictors associated with an increased risk of PVL were age (OR 1.06, 95% CI 1.01–1.12, p = 0.01), a history of transient visual ischemic symptoms (OR 2.62, 95% CI 1.29–5.29, p < 0.01), and jaw claudication (OR 2.11, 95% CI 1.09–4.10, p = 0.03). The presence of fever (OR 0.30, 95% CI 0.14–0.64, p < 0.01) and rheumatic symptoms (OR 0.23, 95% CI 0.10–0.57, p = 0.001) were associated with a markedly reduced risk of developing visual loss (3.7% if features were both present). No laboratory variables were independently associated with PVL.Conclusion.The visual ischemic risk of untreated GCA can be readily estimated upon simple clinical findings, but not laboratory variables. However, we did not identify a subgroup of patients carrying no risk of developing visual loss. Glucocorticoid treatment remains, therefore, urgent for any patient with a high clinical suspicion index.

scholarly journals The association of vascular risk factors with visual loss in giant cell arteritis

Rheumatology ◽  
2016 ◽  
pp. kew397 ◽  
Author(s):  
Max Yates ◽  
Alex J. MacGregor ◽  
Joanna Robson ◽  
Anthea Craven ◽  
Peter A. Merkel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Visual Loss ◽  
Vascular Risk Factors ◽  
Vascular Risk

AB1462-HPR Risk factors for visual loss in giant cell arteritis: a retrospective study of 374 patients

2013 ◽  
Vol 71 (Suppl 3) ◽  
pp. 758.10-758
Author(s):  
A. Zacharof ◽  
T. Margaritis ◽  
A. Kioumourtzis ◽  
G. Galanis ◽  
K. Kouninios
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Visual Loss

scholarly journals POS0803 TRENDS IN THE INCIDENCE OF GIANT CELL ARTERITIS ACROSS SEVEN DECADES AND CHANGES IN DIAGNOSTIC MODALITIES: A POPULATION-BASED STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 654.1-654
Author(s):  
T. Garvey ◽  
C. S. Crowson ◽  
M. Koster ◽  
K. J. Warrington
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Population Based ◽  
Incidence Rates ◽  
Large Vessel ◽  
Vessel Imaging ◽  
Group 3 ◽  
Group 2 ◽  
Diagnostic Modalities ◽  
Incident Cases

Background:Diagnostic methods for giant cell arteritis (GCA) have evolved over recent decades, and large vessel imaging plays an increasing role in disease detection.Objectives:This study aims to estimate the incidence of GCA over the past 10 years in a population and compare it to preceding incidence estimates. It also explores trends in the diagnostic modalities used to identify GCA.Methods:A pre-existing population-based cohort of patients diagnosed with GCA between 1950 and 2009 was extended with incident cases from 2010 to 2019. The diagnosis of GCA was confirmed by review of medical records of patients with ICD9/10 codes for GCA between 1/1/2010 and 12/31/2019. Incident cases that met either one of the following sets of inclusion criteria were added to the cohort: one, American College of Rheumatology 1990 GCA classification criteria; or two, patients aged ≥50 years with elevation of erythrocyte sedimentation rate or C-reactive protein and radiographic evidence of large vessel vasculitis attributed to GCA. Incident cases were classified into one of three groups: group 1, temporal artery biopsy (TAB) positive; group 2, TAB negative or not done with positive large-vessel imaging; or group 3, clinical diagnosis of GCA.Results:The study cohort included 305 patients diagnosed with GCA from 1950 until 2019. Fifty-five incident cases were diagnosed between 2010 and 2019; 37 females (67%) and 18 males (33%). The age and sex adjusted incidence rates (95% CI) per 100,000 between 2010 and 2019 for females, males, and the total population were 13.0 (8.8, 17.3), 8.6 (4.6, 12.7), and 10.8 (8.0, 13.7), respectively. The corresponding incidence rates from 2000-2009 were 28.0 (21.0, 35.1), 10.2 (5.0, 15.5), and 20.5 (15.9, 25.1), respectively. This represents a significant decline in the incidence rates in females (p<0.001) and the total group (p<0.001) between the 2000-2009 and 2010-2019 cohorts but no change in males (p=0.64). Of the 55 patients diagnosed between 2010 and 2019, there were 37 (67%) in group 1, 10 (18%) in group 2, and 8 (15%) in group 3. In contrast, of the 250 patients diagnosed between 1950 and 2009 there were 209 (84%) in group 1, 4 (2%) in group 2, and 37 (15%) in group 3. There was a significant difference between the 1950-2009 and 2010-2019 cohorts in the composition of these groups (p<0.001).Conclusion:In this population-based cohort of patients with GCA diagnosed over a 70-year period, the incidence of GCA has declined in recent years. The total decline is driven by a decline in females but not in males. The reasons for this are unclear but should be followed over time and investigated in other population-based cohorts. There has also been a shift in the diagnostic modalities for GCA. In recent years, there are fewer TAB positive patients, and more patients diagnosed with large vessel imaging. This is the first population-based incidence cohort demonstrating a trend towards increased use of large vessel imaging for the diagnosis of GCA.References:[1]Chandran AK, et al. Incidence of Giant Cell Arteritis in Olmsted County, Minnesota, over a 60-year period 1950-2009. Scand J Rheumatol. 2015;44(3):215-218.[2]Gonzalez-Gay MA, et al. Giant cell arteritis: is the clinical spectrum of the disease changing? BMC Geriatr. 2019; Jul 29;19(1):200.[3]Rubenstein E, et al. Sensitivity of temporal artery biopsy in the diagnosis of giant cell arteritis: a systemic literature review and meta-analysis. Rheumatology (Oxford). 2020 May 1:59(5):1011-1020.Figure 1.Trends in the incidence of GCA in Olmsted County by sex (1950-2019).Acknowledgements:This study was made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the National Institutes of Health (NIH) under Award Number R01 AG034676, and CTSA Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the NIH. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.Disclosure of Interests:Thomas Garvey: None declared, Cynthia S. Crowson: None declared, Matthew Koster: None declared, Kenneth J Warrington Grant/research support from: Clinical research support from Eli Lilly and Kiniksa

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