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Impact of Glucocorticoid Cumulative Doses in a Real-Life Cohort of Patients Affected by Giant Cell Arteritis

Objectives: To describe the impact of cumulative glucocorticoid (GC) doses on related adverse events (AEs) in giant cell arteritis (GCA) in a real-life setting. Methods: The medical charts of the last 139 consecutive GCA patients followed in a tertiary centre were retrospectively analysed. The cumul...

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Autores principales: Castan, Paul, Dumont, Anael, Deshayes, Samuel, Boutemy, Jonathan, Martin Silva, Nicolas, Maigné, Gwénola, Nguyen, Alexandre, Gallou, Sophie, Sultan, Audrey, Aouba, Achille, de Boysson, Hubert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8875204/
https://www.ncbi.nlm.nih.gov/pubmed/35207305
http://dx.doi.org/10.3390/jcm11041034
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author Castan, Paul
Dumont, Anael
Deshayes, Samuel
Boutemy, Jonathan
Martin Silva, Nicolas
Maigné, Gwénola
Nguyen, Alexandre
Gallou, Sophie
Sultan, Audrey
Aouba, Achille
de Boysson, Hubert
author_facet Castan, Paul
Dumont, Anael
Deshayes, Samuel
Boutemy, Jonathan
Martin Silva, Nicolas
Maigné, Gwénola
Nguyen, Alexandre
Gallou, Sophie
Sultan, Audrey
Aouba, Achille
de Boysson, Hubert
author_sort Castan, Paul
collection PubMed
description Objectives: To describe the impact of cumulative glucocorticoid (GC) doses on related adverse events (AEs) in giant cell arteritis (GCA) in a real-life setting. Methods: The medical charts of the last 139 consecutive GCA patients followed in a tertiary centre were retrospectively analysed. The cumulative GC doses were calculated, and the main GC-related AEs were collected during the follow-up. Results: After a median follow-up duration of 35.6 (2–111) months, the median cumulative GC dose in the 139 patients was 9184 (1770–24,640) mg, and 131 patients (94%) presented at least one GC-related AE. Infections (63%) were the most frequently reported GC-related AE, followed by metabolic events (63%), including weight gain in 51% of them. Cardiovascular and neuropsychiatric events occurred in 51% and 47% of patients, respectively. Osteoporotic fractures, muscular involvement, digestive events, geriatric deterioration, skin fragility, ophthalmologic complications and hypokalaemia were reported in <35% of patients. Cardiovascular events (p = 0.01), osteoporotic fractures (p = 0.004), cataract occurrence (p = 0.03), weight gain (p = 0.04) and infections (p = 0.01) were significantly associated with GC cumulative doses > 9 g. Longer GC durations were associated with cataract occurrence (p = 0.01), weight gain (p = 0.03) and all-grade infections (p = 0.048), especially herpes zoster occurrence (p = 0.003). Neuropsychiatric and metabolic events appeared within the first months after GC introduction, whereas herpes zoster recurred, and most cardiovascular AEs emerged after 1 year. Geriatric events, especially osteoporotic fractures, occurred 2 years after GC introduction. Conclusion: This study highlights how frequent GC-related AEs are and the impact of prolonged GC and cumulative doses.
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spelling pubmed-88752042022-02-26 Impact of Glucocorticoid Cumulative Doses in a Real-Life Cohort of Patients Affected by Giant Cell Arteritis Castan, Paul Dumont, Anael Deshayes, Samuel Boutemy, Jonathan Martin Silva, Nicolas Maigné, Gwénola Nguyen, Alexandre Gallou, Sophie Sultan, Audrey Aouba, Achille de Boysson, Hubert J Clin Med Article Objectives: To describe the impact of cumulative glucocorticoid (GC) doses on related adverse events (AEs) in giant cell arteritis (GCA) in a real-life setting. Methods: The medical charts of the last 139 consecutive GCA patients followed in a tertiary centre were retrospectively analysed. The cumulative GC doses were calculated, and the main GC-related AEs were collected during the follow-up. Results: After a median follow-up duration of 35.6 (2–111) months, the median cumulative GC dose in the 139 patients was 9184 (1770–24,640) mg, and 131 patients (94%) presented at least one GC-related AE. Infections (63%) were the most frequently reported GC-related AE, followed by metabolic events (63%), including weight gain in 51% of them. Cardiovascular and neuropsychiatric events occurred in 51% and 47% of patients, respectively. Osteoporotic fractures, muscular involvement, digestive events, geriatric deterioration, skin fragility, ophthalmologic complications and hypokalaemia were reported in <35% of patients. Cardiovascular events (p = 0.01), osteoporotic fractures (p = 0.004), cataract occurrence (p = 0.03), weight gain (p = 0.04) and infections (p = 0.01) were significantly associated with GC cumulative doses > 9 g. Longer GC durations were associated with cataract occurrence (p = 0.01), weight gain (p = 0.03) and all-grade infections (p = 0.048), especially herpes zoster occurrence (p = 0.003). Neuropsychiatric and metabolic events appeared within the first months after GC introduction, whereas herpes zoster recurred, and most cardiovascular AEs emerged after 1 year. Geriatric events, especially osteoporotic fractures, occurred 2 years after GC introduction. Conclusion: This study highlights how frequent GC-related AEs are and the impact of prolonged GC and cumulative doses. MDPI 2022-02-16 /pmc/articles/PMC8875204/ /pubmed/35207305 http://dx.doi.org/10.3390/jcm11041034 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Castan, Paul
Dumont, Anael
Deshayes, Samuel
Boutemy, Jonathan
Martin Silva, Nicolas
Maigné, Gwénola
Nguyen, Alexandre
Gallou, Sophie
Sultan, Audrey
Aouba, Achille
de Boysson, Hubert
Impact of Glucocorticoid Cumulative Doses in a Real-Life Cohort of Patients Affected by Giant Cell Arteritis
title Impact of Glucocorticoid Cumulative Doses in a Real-Life Cohort of Patients Affected by Giant Cell Arteritis
title_full Impact of Glucocorticoid Cumulative Doses in a Real-Life Cohort of Patients Affected by Giant Cell Arteritis
title_fullStr Impact of Glucocorticoid Cumulative Doses in a Real-Life Cohort of Patients Affected by Giant Cell Arteritis
title_full_unstemmed Impact of Glucocorticoid Cumulative Doses in a Real-Life Cohort of Patients Affected by Giant Cell Arteritis
title_short Impact of Glucocorticoid Cumulative Doses in a Real-Life Cohort of Patients Affected by Giant Cell Arteritis
title_sort impact of glucocorticoid cumulative doses in a real-life cohort of patients affected by giant cell arteritis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8875204/
https://www.ncbi.nlm.nih.gov/pubmed/35207305
http://dx.doi.org/10.3390/jcm11041034
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