Polymyalgia rheumatica and giant cell arteritis-three challenges-consequences of the vasculitis process, osteoporosis, and malignancy: A prospective cohort study protocol

Medicine (Baltimore). 2017 Jun;96(26):e7297. doi: 10.1097/MD.0000000000007297.

Abstract

Introduction: Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are common inflammatory conditions. The diagnosis of PMR/GCA poses many challenges since there are no specific diagnostic tests. Recent literature emphasizes the ability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) to assess global disease activity in inflammatory diseases. 18F-FDG PET/CT may lead to the diagnosis at an earlier stage than conventional imaging and may also assess response to therapy. With respect to the management of PMR/GCA, there are 3 significant areas of concern as follows: vasculitis process/vascular stiffness, malignancy, and osteoporosis.

Methods and analysis: All patients with suspected PMR/GCR referred to the Rheumatology section of Medicine Department at Svendborg Hospital, Denmark. The 4 separate studies in the current protocol focus on: the association of clinical picture of PMR/GCA with PET findings; the validity of 18F-FDG PET/CT scan for diagnosis of PMR/GCA compared with temporal artery biopsy; the prevalence of newly diagnosed malignancies in patients with PMR/GCA, or PMR-like syndrome, with the focus on diagnostic accuracy of 18F-FDG PET/CT scan compared with conventional workup (ie, chest X-ray/abdominal ultrasound); and the impact of disease process, and also steroid treatment on bone mineral density, body composition, and vasculitis/vascular stiffness in PMR/GCA patients.

Ethics and dissemination: The study has been approved by the Regional Ethics Committee of the Region of Southern Denmark (identification number: S-20160098) and Danish Data Protection Agency (J.nr 16/40522). Results of the study will be disseminated via publications in peer-reviewed journals, and presentation at national and international conferences.

Publication types

  • Clinical Trial

MeSH terms

  • Biopsy
  • Denmark
  • Fluorodeoxyglucose F18
  • Giant Cell Arteritis / complications
  • Giant Cell Arteritis / diagnosis*
  • Giant Cell Arteritis / drug therapy*
  • Giant Cell Arteritis / physiopathology
  • Humans
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / epidemiology
  • Osteoporosis / chemically induced
  • Osteoporosis / physiopathology
  • Patient Selection
  • Polymyalgia Rheumatica / complications
  • Polymyalgia Rheumatica / diagnosis*
  • Polymyalgia Rheumatica / drug therapy*
  • Polymyalgia Rheumatica / physiopathology
  • Positron Emission Tomography Computed Tomography
  • Prednisolone / adverse effects
  • Prednisolone / therapeutic use*
  • Prevalence
  • Radiopharmaceuticals
  • Single-Blind Method
  • Steroids / adverse effects
  • Steroids / therapeutic use*
  • Temporal Arteries / pathology
  • Vasculitis / physiopathology

Substances

  • Radiopharmaceuticals
  • Steroids
  • Fluorodeoxyglucose F18
  • Prednisolone