Background: Large vessel vasculitides are known relapsing diseases. However, the rate of relapses has been seldom addressed and there are only few data on relapse predictors.
Objectives: We conducted the present study to investigate the prevalence of relapses in the first year after diagnosis and the overall relapse among patients with large vessel vasculitis. Furthermore, we aimed to identify if the systemic inflammatory response (SIR) is a possible predictor for relapse among patients with large cell vasculitis.
Methods: The systemic inflammatory response (SIR) has been described as a potential clinical and serological score predicting the risk for relapses1. SIR estimates the systemic inflammatory activity at the time point of first diagnosis1. It was defined as follows: Temperature >38°C, weight loss >4kg, Haemoglobin <11 g/dl and erythrocyte sedimentation rate >85 mm/h. For each of the above-mentioned criteria one point was attributed, leading to a range from 0 to 4 points. Patients with 3 to 4 points were considered having a highly inflammatory response and patients with an SIR ≤ 2 were considered having a low inflammatory response and thus a lower risk for relapses. Relapses are defined as reappearance of disease-related symptoms requiring treatment adjustment. The study cohort included 75 patients with large cell vasculitis (Giant Cell Vasculitis, Takayasu Vasculitis, inflammatory non-infections Aortitis), longitudinally followed by the authors over a mean period of 5.2 ± 3.3 years (range 1-14 yr).
Results: The study-cohort includes 71 patients with a mean age at diagnosis of 63.5 (16 – 85) years. Almost three quarters (73%) of the patients were women. Most of the patients were suffering from GCA (73.2%), followed by Takayasu arteritis (16.9%) and inflammatory non-infections Aortitis (9.8%). 38 patients (53.5%) relapsed at least once during the follow up, and 17 patients had two or more relapses. The vast majority of relapses (86.8%) were observed within the first year following diagnosis. Most of the patients, 54 patients (76%), were considered having a low inflammatory response (SIR <=2). The relapse rate in this group was 59.2%. On the other hand, there were 17 patients having an SIR higher or equal to 3 points. The relapse rate in this group was 33%.
Conclusion: In conclusion, the results of this preliminary study reveal that the relapse rate among patients with large vessel vasculitis high is. The SRI appears to be an inadequate predictor for relapse in this cohort.
References: Alba MA, García-Martínez A, Prieto-González S, et al. Relapses in patients with giant cell arteritis: prevalence, characteristics, and associated clinical findings in a longitudinally followed cohort of 106 patients. Medicine (Baltimore). 2014;93(5):194–201.
Disclosure of Interests: Vasile-Mihai Coroian: None declared, Sebastian Saur: None declared, Ann-Christin Pecher: None declared, Theodoros Xenitidis: None declared, Jörg Henes Grant/research support from: Novartis, Roche-Chugai, Consultant of: Novartis, Roche, Celgene, Pfizer, Abbvie, Sanofi, Boehringer-Ingelheim,
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