AUTHOR=Mahr Alfred , Hachulla Eric , de Boysson Hubert , Guerroui Nassim , Héron Emmanuel , Vinzio Stéphane , Broner Jonathan , Lapébie François-Xavier , Michaud Martin , Sailler Laurent , Zenone Thierry , Djerad Mohamed , Jouvray Mathieu , Shipley Emilie , Tieulie Nathalie , Armengol Guillaume , Bouldoires Bastien , Viallard Jean-Francois , Idier Isabelle , Paccalin Marc , Devauchelle-Pensec Valérie 

TITLE=Presentation and Real-World Management of Giant Cell Arteritis (Artemis Study)

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.732934

DOI=10.3389/fmed.2021.732934

ISSN=2296-858X

ABSTRACT=<p><bold>Background:</bold> Few studies of daily practice for patients with giant cell arteritis (GCA) are available. This French study aimed to describe the characteristics and management of GCA in a real-life setting.</p><p><bold>Methods:</bold> Cross-sectional, non-interventional, multicenter study of patients ≥50 years old who consulted hospital-based specialists for GCA and were under treatment. Patient characteristics and journey, diagnostic methods and treatments were collected. Descriptive analyses were performed.</p><p><bold>Results:</bold> In total, 306 patients (67% females, mean age 74 ± 8 years old) were recruited by 69 physicians (internists: 85%, rheumatologists: 15%); 13% of patients had newly diagnosed GCA (diagnosis-to-visit interval &lt;6 weeks). Overall median disease duration was 13 months (interquartile range 5–26). Most patients were referred by general practitioners (56%), then ophthalmologists (10%) and neurologists (7%). Most common comorbidities were hypertension (46%), psychiatric disorders (10%), dyslipidemia (12%), diabetes (9%), and osteoporosis (6%). Initial GCA presentations included cranial symptoms (89%), constitutional symptoms (74%), polymyalgia rheumatica (48%), and/or other extra-cranial manifestations (35%). Overall, 85, 31, 26, and 30% of patients underwent temporal artery biopsy, high-resolution temporal artery Doppler ultrasonography, <sup>18</sup>FDG-PET, and aortic angio-CT, respectively. All patients received glucocorticoids, which were ongoing for 89%; 29% also received adjunct medication(s) (methotrexate: 19%, tocilizumab: 15%). A total of 40% had relapse(s); the median time to the first relapse was 10 months. Also, 37% had comorbidity(ies) related to or aggravated by glucocorticoids therapy.</p><p><bold>Conclusion:</bold> This large observational study provides insight into current medical practices for GCA. More than one third of patients had comorbidities related to glucocorticoid therapy for a median disease duration of 13 months. Methotrexate and tocilizumab were the most common adjunct medications.</p>