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Title: | Epidemiology and predictors of relapse in giant cell arteritis: A systematic review and meta-analysis | Authors: | Moreel, Lien Betrains, Albrecht MOLENBERGHS, Geert Vanderschueren, Steven Blockmans, Daniel |
Issue Date: | 2023 | Publisher: | ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER | Source: | JOINT BONE SPINE, 90 (1) (Art N° 105494) | Abstract: | Objectives: The aim of this study was to estimate the timing of relapse, the prevalence of multiple relapses and the predictors of relapse in patients with giant cell arteritis (GCA).Methods: PubMed, Embase and Cochrane databases were searched from inception till November, 30 2021. Outcome measures include cumulative relapse rate (CRR) of first relapse at year 1, 2, and 5 after treatment initiation, CRR of second and third relapse and predictors of relapse. Results: Thirty studies (2595 patients) were included for timing of relapse, 16 studies (1947 patients) for prevalence of multiple relapses and 40 studies (4213 patients) for predictors of relapse. One-year, 2-year and 5-year CRRs were 32% [95% confidence interval (CI) 22-43%], 44% [95% CI 31-59%], and 47% [95% CI 27-67%], respectively. The duration of scheduled glucocorticoid therapy was negatively associated with the 1-year CRR (P = 0.03). CRR of second and third relapse were 30% [95% CI 21-40] and 17% [95% CI 8-33%], respectively. Female sex (OR 1.43) and large vessel involvement (OR 2.04) were predictors of relapse.Conclusion: Relapse occurred in almost half of GCA patients mainly during the first two years after diagnosis. One in three patients had multiple relapses. The optimal glucocorticoid tapering schedule, which seeks a balance between the lowest relapse risk and the shortest glucocorticoid duration, needs to be determined in future studies. Longer scheduled glucocorticoid therapy or early introduction of glucocorticoid-sparing agents may be warranted in female patients and patients with large vessel involve-ment.(c) 2022 Societe franc , aise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved. | Notes: | Moreel, L (corresponding author), Univ Hosp Leuven, Gen Internal Med Dept, Herestr 49, B-3000 Leuven, Belgium. Lien.Moreel@uzleuven.be |
Keywords: | Giant cell arteritis;GCA;Relapse | Document URI: | http://hdl.handle.net/1942/39282 | ISSN: | 1297-319X | e-ISSN: | 1778-7254 | DOI: | 10.1016/j.jbspin.2022.105494 | ISI #: | 000902129000002 | Rights: | 2022 Societ´ e´ franc¸ aise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved. | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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