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The use of intravenous methylprednisolone in giant cell arteritis : a population-based study

Henningson, Hampus ; Hammar, Björn LU and Mohammad, Aladdin J. LU (2025) In Rheumatology 64(4). p.2083-2090
Abstract

Objectives: To determine clinical characteristics, outcome and occurrence of comorbidities in patients with biopsy-confirmed giant cell arteritis (GCA) treated with intravenous methylprednisolone (IVMP) vs those receiving oral glucocorticoids (OGC) only. Methods: A retrospective study included patients with GCA diagnosed from 2004 through 2019. Clinical and laboratory characteristics, and cumulative GC dose were compared in patients receiving IVMP vs OGCs. Changes in visual acuity (VA), occurrence of comorbidities after GCA diagnosis, and mortality were analysed. Results: A total of 419 patients (69% female) were included. In total, 111 patients were initially treated with IVMP, 104 (94%) of whom showed visual manifestations at onset... (More)

Objectives: To determine clinical characteristics, outcome and occurrence of comorbidities in patients with biopsy-confirmed giant cell arteritis (GCA) treated with intravenous methylprednisolone (IVMP) vs those receiving oral glucocorticoids (OGC) only. Methods: A retrospective study included patients with GCA diagnosed from 2004 through 2019. Clinical and laboratory characteristics, and cumulative GC dose were compared in patients receiving IVMP vs OGCs. Changes in visual acuity (VA), occurrence of comorbidities after GCA diagnosis, and mortality were analysed. Results: A total of 419 patients (69% female) were included. In total, 111 patients were initially treated with IVMP, 104 (94%) of whom showed visual manifestations at onset and 308 received OGCs only. Ninety patients (21.5%) exhibited visual involvement at onset, verified by an ophthalmologist. Compared with OGC, patients receiving IVMP exhibited lower inflammatory response at presentation. There was a tendency for improvement in VA with the use of IVMP, but the results were not statistically significant (OR 1.19, 95% CI 0.35–4.01). Patients treated with IVMP had a higher risk of newly diagnosed diabetes mellitus within a year of GCA diagnosis (OR 2.59, 95% CI 1.19–5.63). This risk remained elevated after adjusting for cumulative OGC dose at three months (adjusted OR 3.30, 95% CI 1.29–8.43). There was no difference in survival between treatment groups. Conclusions: Our study found no evidence supporting any benefit of using IVMP in improving VA or survival. IVMP may increase diabetes risk within a year of GCA diagnosis. Further studies are needed to evaluate the value of IVMP in GCA.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
comorbidities, giant cell arteritis, intravenous methylprednisolone, outcome, survival, visual manifestations
in
Rheumatology
volume
64
issue
4
pages
8 pages
publisher
Oxford University Press
external identifiers
  • scopus:105001946224
  • pmid:39190002
ISSN
1462-0324
DOI
10.1093/rheumatology/keae459
language
English
LU publication?
yes
id
f080c605-2ae9-412c-83ca-1737c6a54439
date added to LUP
2025-08-19 12:37:14
date last changed
2025-11-11 20:15:11
@article{f080c605-2ae9-412c-83ca-1737c6a54439,
  abstract     = {{<p>Objectives: To determine clinical characteristics, outcome and occurrence of comorbidities in patients with biopsy-confirmed giant cell arteritis (GCA) treated with intravenous methylprednisolone (IVMP) vs those receiving oral glucocorticoids (OGC) only. Methods: A retrospective study included patients with GCA diagnosed from 2004 through 2019. Clinical and laboratory characteristics, and cumulative GC dose were compared in patients receiving IVMP vs OGCs. Changes in visual acuity (VA), occurrence of comorbidities after GCA diagnosis, and mortality were analysed. Results: A total of 419 patients (69% female) were included. In total, 111 patients were initially treated with IVMP, 104 (94%) of whom showed visual manifestations at onset and 308 received OGCs only. Ninety patients (21.5%) exhibited visual involvement at onset, verified by an ophthalmologist. Compared with OGC, patients receiving IVMP exhibited lower inflammatory response at presentation. There was a tendency for improvement in VA with the use of IVMP, but the results were not statistically significant (OR 1.19, 95% CI 0.35–4.01). Patients treated with IVMP had a higher risk of newly diagnosed diabetes mellitus within a year of GCA diagnosis (OR 2.59, 95% CI 1.19–5.63). This risk remained elevated after adjusting for cumulative OGC dose at three months (adjusted OR 3.30, 95% CI 1.29–8.43). There was no difference in survival between treatment groups. Conclusions: Our study found no evidence supporting any benefit of using IVMP in improving VA or survival. IVMP may increase diabetes risk within a year of GCA diagnosis. Further studies are needed to evaluate the value of IVMP in GCA.</p>}},
  author       = {{Henningson, Hampus and Hammar, Björn and Mohammad, Aladdin J.}},
  issn         = {{1462-0324}},
  keywords     = {{comorbidities; giant cell arteritis; intravenous methylprednisolone; outcome; survival; visual manifestations}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{2083--2090}},
  publisher    = {{Oxford University Press}},
  series       = {{Rheumatology}},
  title        = {{The use of intravenous methylprednisolone in giant cell arteritis : a population-based study}},
  url          = {{http://dx.doi.org/10.1093/rheumatology/keae459}},
  doi          = {{10.1093/rheumatology/keae459}},
  volume       = {{64}},
  year         = {{2025}},
}