Table 1. Comparison of baseline characteristics at GCA diagnosis and outcomes of 91 GCA patients with LVV treated with TCZ according to their metabolic response on repeated 18FDG-PET-CT.
| Total n=91 |
Metabolic extinction n=69 |
No metabolic extinction n=22 |
P value | |
|---|---|---|---|---|
| Demographics | ||||
| Female | 64 (70) | 45 (65) | 19 (86) | 0.06 |
| Median age (years) | 69 (66–75) | 70 (65–75) | 69 (66–75) | 0.93 |
| Cardiovascular risk factors | ||||
| Tobacco use | 28 (31) | 23 (33) | 5 (23) | 0.34 |
| Arterial hypertension | 39 (43) | 28 (41) | 11 (50) | 0.44 |
| Diabetes mellitus | 5 (5) | 4 (6) | 1 (5) | 1 |
| Dyslipidaemia | 24 (26) | 18 (26) | 6 (27) | 0.91 |
| History of strokes | 4 (4) | 2 (3) | 2 (9) | 0.25 |
| History of coronary disease | 11 (12) | 10 (14) | 1 (5) | 0.28 |
| Clinical manifestations at baseline | ||||
| Body mass index, kg/m2 | 24.2 (21.5–27.1) n=49 |
24.2 (21.5–26.4) n=33 |
23.9 (21.5–28.4) n=16 |
0.69 |
| Cranial manifestations | 65 (71) | 49 (71) | 16 (73) | 0.87 |
| Ophthalmic involvement | 14 (15) | 9 (13) | 5 (23) | 0.31 |
| Limb claudication | 6 (7) | 4 (6) | 2 (9) | 0.63 |
| Polymyalgia rheumatica | 50 (55) | 40 (58) | 10 (45) | 0.30 |
| Diagnosis of LVV on PET/CT | ||||
| GCA and LVV diagnosed concomitantly | 65 (71) | 52 (75) | 13 (59 | 0.14 |
| Elapsed time in others, months | 8.5 (6–15) | 8.5 (6–13.5) | 8 (6–16) | 0.89 |
| Laboratory tests, at baseline | ||||
| Fibrinogen, g/L | 6.8 (4.7–8) n=34 |
7 (4.5–8) n=24 |
7 (5–7.6) n=10 |
0.82 |
| C reactive protein, mg/L | 79 (40–134) n=78 |
85 (39–132) n=60 |
76 (38–141) n=18 |
0.87 |
| Haemoglobin, g/L | 112 (104–122) n=57 |
113 (104–123) n=43 |
111 (97–120) n=14 |
0.72 |
| Positive histology | 53/77 (69) | 37/55 (67) | 16/20 (80) | 0.28 |
| GC management | ||||
| GC doses at onset, mg/day | 45 (40–60) | 45 (40–60) | 50 (40–60) | 0.58 |
| GC discontinuation at last FU | 72 (79) | 61 (88) | 11 (50) | 0.0003 |
| Elapsed time to GC discontinuation, months | 12 (10–18) | 12 (9–16.5) | 18 (13–30) | 0.02 |
| Median GC dose at last FU in others, mg/day | 5 (4–12) | 5 (1–7) | 5 (5–15) | 0.81 |
| TCZ management | ||||
| Use of any IS before TCZ | 16 (18) | 10 (14) | 6 (27) | 0.20 |
| TCZ start at GCA diagnosis | 38 (45) | 31 (45) | 7 (32) | 0.28 |
| Elapsed time in others, months | 13 (8–20) | 13 (9–19) | 14 (6–24) | 0.86 |
| Discontinuation of TCZ at last follow-up | 46 (51) | 41 (59) | 5 (23) | 0.003 |
| Duration of TCZ in those who stop | 14 (12–20) | 14 (12–20) | 13 (11–21) | 0.47 |
| GCA relapses | ||||
| Any GCA relapse | 58 (64) | 38 (55) | 20 (91) | 0.002 |
| Any GCA relapse before TCZ | 54 (55) | 38 (55) | 16 (73) | 0.21 |
| LVV relapse after TCZ | 13 (16) | 3 (4) | 10 (45) | <0.0001 |
| Death | 2 (2) | 2 (3) | 0 (0) | 1 |
| Follow-up (months) | 33 (15–53) | 32 (14–48) | 46 (17–60) | 0.21 |
| Time between PET/CT 1 and 2, months | 11 (7–14) | 11 (7–14) | 12 (7–15) | 0.43 |
| Follow-up after last PET/CT, months | 12 (2–27) | 15 (3–31) | 9 (0–16) | 0.08 |
Values are numbers (%) or medians (IQR).
FU, follow-up; GC, glucocorticoids; GCA, giant cell arteritis; IS, immunosuppressants; LVV, large vessel vasculitis; PET, positron emission tomography; TCZ, tocilizumab.