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FRI0168 Longterm therapy in temporal arteritis: analysis of adverse effects
  1. C Resende,
  2. JE Fonseca,
  3. H Canhão,
  4. JC Teixeira Costa,
  5. JA Pereira Silva,
  6. M Viana Queiroz
  1. Rheumatology Unit, Santa Maria Hospital, Lisbon, Portugal

Abstract

Background Temporal arteritis (TA) is a serious disease and require a prolonged period of steroid therapy.

Objectives With the aim of clarifying if steroid cumulative dose is a significative risk factor for adverse effects, we performed a study of 20 TA patients, attending the rheumatology out-patients clinic of Santa Maria Hospital, Lisbon, with a minimum follow-up time of 2 years.

Results The mean follow-up period was 84.3 ± 28.9 months. 12 patients were female (60%, mean age at the time of diagnosis of 69.4 ± 8.6 years) and 8 were male (40%, mean age at the time of diagnosis of 64.6 ± 7.7 years). All the patients were treated with prednisone (PDN), 2 with 3 × 1000 mg methylprednisolone pulses and 4 with concomitant immunosupressors (3 azathioprine and 1 cyclophosphamide). The mean initial PDN dose was 53,2 mg. The PDN dose was tapered and the mean doses were: 1st month – 49,9 ± 18,7 mg; 3rd month ? 34,0 ± 19,1 mg; 6th month ? 24,9 ± 17,7 mg; 12th month ? 10,5 ± 7,8 mg; 24th month ? 5,9 ± 3,2 mg; 36th month ? 5,6 ± 3,2 mg; 60th month ? 7,8 ± 8,6 mg; 84th month ? 5,3 ± 2,8 mg.

By the end of the first 6 months 50% of the baseline dose was reached and after 2 years all patients were on a maintenance low dose (5.9 mg). 2 patients (10%) were able to stop the PDN (at 48 and 55 months). The mean cumulative PDN dose was 17641,8 ± 8937,3 mg. 17 (85%) patients had corticosteroid related adverse effects. Although these patients had a mean cumulative PDN dose (19064,2 ± 8880,7 mg) superior to the dose of the patients without adverse effects (9575 ± 3401,5 mg), the difference was not statistically significative. The mean cumulative PDN dose for each of the observed adverse effects is characterised in the next Table 1.

Abstract FRI0168 Table 1

Conclusion Our results suggest that PDN cumulative dose is a major factor in the induction of hyperglycemia and cataracts. All the others adverse effects had a trend to be correlated with higher PDN doses but this observation did not reach a statistically significative difference.

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