19. Predictors of Relapse in Giant Cell Arteritis

Background: Giant cell arteritis (GCA) is a systemic vasculitis which manifests as headaches and ischemic symptoms that can lead to vision loss. Treatment of GCA often requires more than a year of glucocorticoids, with or without a glucocorticoid-sparing agent, and can be complicated by episodes of recurrence. Here, we evaluate predictors of GCA recurrence over a decade at a tertiary hospital.

Methods:  We conducted a retrospective chart review for patients with GCA followed at the Hôpital du Sacré-Coeur de Montreal from ­­­2010 through 2020. Data extracted included patient’s age, sex, baseline comorbidities (diabetes and hypertension), clinical features (weight loss, fatigue, headache, jaw claudication or polymyalgia rheumatica) and prednisone dose at initial presentation. We analyzed these factors as predictors of relapse, including survival analyses for time to first relapse.

Results:  Among 93 patients, 23 (25%) had disease recurrence over a median follow-up of 562 days (IQR 368 days). Eighty (86%) patients were female. Thirteen (14%) had diabetes, whereas 52 (56%) had hypertension at baseline. For clinical features, 42 (45%) patients had weight loss, 46 (49%) had fatigue, 84 (90%) had headache, 58 (62%) had jaw claudication and 38 (41%) had PMR. There were no differences in relapse risk by demographic factors, comorbidities, or initial presenting clinical features. However, patients that received a higher dose of prednisone at presentation were shown to have less risk of relapse [hazard ratio (HR) .97 (95% CI 0.95, 1.00)].

Conclusions:  Our study did not demonstrate diabetes, hypertension or clinical features at initial presentation to be associated with higher relapses. A higher dose of initial prednisone results was associated with less relapses.

Disclosures:  None