Prognosis of large vessel involvement in large vessel vasculitis

Mathieu Vautier; Axelle Dupont; Hubert de Boysson; Chloé Comarmond; Tristan Mirault; Arsène Mekinian; Marc Lambert; Yasmina Ferfar; Achille Aouba; Patrice Cacoub; Matthieu Resche-Rigon; David Saadoun

doi:10.1016/j.jaut.2020.102419

Prognosis of large vessel involvement in large vessel vasculitis

J Autoimmun. 2020 Mar:108:102419. doi: 10.1016/j.jaut.2020.102419. Epub 2020 Feb 5.

Affiliations

¹ Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, Centre de Référence des Maladies Auto- Inflammatoires, F-75013, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, And Inflammation- Immunopathology-Biotherapy Department (DHU I2B), F-75005, Paris, France; INSERM, UMR_S 959, F-75013, Paris, France; CNRS, FRE3632, F-75005, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, France.
² APHP Department of Biostatistics and Medical Information, Hôpital Saint-Louis; ECSTRA Team, CRESS UMR 1153, INSERM, Paris Diderot University, France.
³ Department of Internal Medecine, Caen University Hospital, University of Caen-Basse Normandie, France.
⁴ Centre de Référence des Maladies Vasculaires Rares, Hôpital Européen Georges-Pompidou, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France; INSERM U970 PARCC, Paris Descartes University, Sorbonne Paris Cité University, Paris, France.
⁵ Hôpital Saint-Antoine-APHP-Service de Médecine Interne, Paris, France.
⁶ Hôpital Claude Huriez, Service de Médecine Interne, Centre de Référence des Maladies Auto- Immunes et Systémiques Rares du Nord et Nord-Ouest (CeRAINAO), CHU, Université de Lille, Lille, France.
⁷ Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, Centre de Référence des Maladies Auto- Inflammatoires, F-75013, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, And Inflammation- Immunopathology-Biotherapy Department (DHU I2B), F-75005, Paris, France; INSERM, UMR_S 959, F-75013, Paris, France; CNRS, FRE3632, F-75005, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, France. Electronic address: [email protected].

PMID: 32035747
DOI: 10.1016/j.jaut.2020.102419

Abstract

Objectives: To assess prognosis factors and outcome of large vessel involvement (LVI) in large vessels vasculitis (LVV) patients.

Methods: Retrospective multicenter study of characteristics and outcomes of 417 patients with LVI including 299 Takayasu arteritis (TAK) and 118 Giant cell arteritis (GCA-LVI) were analyzed. Logistic regression analysis assessed prognosis factors in LVV patients. Outcome of LVI among TAK and GCA-LVI patients (ischemic complications, aneurysms complications, relapses and revascularization) were assessed.

Results: In multivariable analysis, stroke/transient ischemic attack [HR: 3.63 (1.46-9.04), p = 0.006] was independently associated with vascular complications in LVV. The 10-years aneurysm free survival was significantly lower [67% (48-93) vs 89% (84-95), p = 0.02] in GCA-LVI compare to TAK patients. The 5-years relapse free survival was significantly lower [47% (37-60) vs 69% (63-75), p < 0.001,] in GCA-LVI compare to TAK patients. The 10-years revascularization free survival was significantly lower [55% (48-64) vs 76% (59-99), p < 0.001] in TAK compare to GCA-LVI patients. After a median follow-up of 5 years, 16 (5.4%) TAK and 7 (5.9%) GCA-LVI patients died, mainly of aneurysm (26%) and ischemic complications (26%).

Conclusion: This large nationwide cohort of LVI provided prognosis factors of vascular complications in LVV patients. TAK and GCA-LVI have different long-term outcome in term of aneurysm development, relapse and revascularization.

Keywords: Giant cell arteritis; Outcome; Prognosis; Takayasu arteritis; Vasculitis.

Publication types

Multicenter Study

MeSH terms

Comorbidity
Giant Cell Arteritis / diagnosis
Giant Cell Arteritis / epidemiology*
Giant Cell Arteritis / etiology
Humans
Mortality
Patient Outcome Assessment
Prognosis
Public Health Surveillance
Takayasu Arteritis / diagnosis
Takayasu Arteritis / epidemiology*
Takayasu Arteritis / etiology