Objectives To assess the sensitivity to change of ultrasound halo features and their association with disease activity and glucocorticoid (GC) treatment in patients with newly diagnosed giant cell arteritis (GCA).
Methods Prospective study of patients with ultrasound-confirmed GCA who underwent serial ultrasound assessments of the temporal artery (TA) and axillary artery (AX) at fixed time points. The number of segments with halo and maximum halo intima–media thickness (IMT) was recorded. Time points in which >80% of patients were assessed were considered for analysis. Halo features at disease presentation and first relapse were compared.
Results 49 patients were assessed at 354 visits. Halo sensitivity to change was assessed at weeks 1, 3, 6, 12 and 24 and showed a significant standardised mean difference between all time points and baseline for the TA halo features but only after week 6 for the AX halo features. The number of TA segments with halo and sum and maximum TA halo IMT showed a significant correlation with erythrocyte sedimentation rate (0.41, 0.44 and 0.48), C reactive protein (0.34, 0.39 and 0.41), Birmingham Vasculitis Activity Score (0.29, 0.36 and 0.35) and GC cumulative dose (−0.34, −0.37 and −0.32); no significant correlation was found for the AX halo features. Halo sign was present in 94% of first disease relapses but with a lower mean number of segments with halo and sum of halo IMT compared with disease onset (2.93±1.59 mm vs 4.85±1.51 mm, p=0.0012; 2.01±1.13 mm vs 4.49±1.95 mm, p=0.0012).
Conclusions Ultrasound is a useful imaging tool to assess disease activity and response to treatment in patients with GCA.
- giant cell arteritis
- systemic vasculitis
Data availability statement
Data are available upon reasonable request.
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Handling editor Josef S Smolen
CP and SM contributed equally.
Correction notice This article has been corrected since it published Online First. The author affiliations have been amended.
Contributors All listed authors provided substantial contributions to this work. CP, SM, WS and RAL were involved in its conception and design. CP, SM, PD, NK, AM, VT, FB, FS, CM and JEF contributed to the acquisition of data. CAS conducted the statistical analyses. CP, SM, RAL and WS contributed to the interpretation of data. CP, SM, CAS and RAL drafted the manuscript. All authors contributed to the critical revision of the manuscript and agreed on its final version.
Funding CP’s work was supported in part by a grant from the Portuguese Society of Rheumatology.
Competing interests None declared.
Patient and public involvement statement Patients or the public were not involved in the design, conduct, reporting or dissemination plans of our research.
Provenance and peer review Not commissioned; externally peer reviewed.
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