J Rheum Dis.  2024 Jul;31(3):160-170. 10.4078/jrd.2024.0007.

Clinical characteristics and courses of Korean patients with giant cell arteritis: a multi-center retrospective study

• Lee JI
• Park JW
• Jung Y
• Shin K
• Choi SR
• Kang EH
• Lee YJ
• Yoo JJ
• Ha YJ

• KMID: 2557385
• DOI: http://doi.org/10.4078/jrd.2024.0007

Abstract

Objective
Giant cell arteritis (GCA) is a large-vessel vasculitis that primarily affects elderly individuals. However, data regarding Korean patients with GCA are scarce owing to its extremely low prevalence in East Asia. This study aimed to investigate the clinical characteristics of Korean patients with GCA and their outcomes, focusing on relapse.
Methods
The medical records of 27 patients with GCA treated at three tertiary hospitals between 2007 and 2022 were retrospectively reviewed.
Results
Seventeen (63.0%) patients were females, and the median age at diagnosis was 75 years. Large vessel involvement (LVI) was detected in 12 (44.4%) patients, and polymyalgia rheumatica (PMR) was present in 14 (51.9%) patients. Twelve (44.4%) patients had fever at onset. The presence of LVI or concurrent PMR at diagnosis was associated with a longer time to normalization of the C-reactive protein level (p=0.039) or erythrocyte sedimentation rate (p=0.034). During follow-up (median: 33.8 months), four (14.8%) patients experienced relapse. Kaplan-Meier analyses showed that relapse was associated with visual loss (p=0.008) and the absence of fever (p=0.004) at onset, but not with LVI or concurrent PMR.
Conclusion
Concurrent PMR and LVI were observed in approximately half of Korean patients with GCA, and the elapsed time to normalization of inflammatory markers in these patients was longer. The relapse rate in Korean GCA is lower than that in Western countries, and afebrile patients or patients with vision loss at onset have a higher risk of relapse, suggesting that physicians should carefully monitor patients with these characteristics.

Keyword

Giant cell arteritis; Polymyalgia rheumatica; Recurrence

Figure

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  Figure 1 Kaplan-Meier curves for relapse-free survival of patients with giant cell arteritis. Relapse-free survival is estimated using the Kaplan-Meier method and is delineated according to the presence or absence of (A) vision loss at onset, (B) fever at onset, (C) LVI, and (D) PMR. LVI: large vessel involvement, PMR: polymyalgia rheumatic.

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