Joint bone spine · 2026
Complete Metabolic Remission on PET/CT Following Glucocorticoids Monotherapy in Giant Cell Arteritis-related Large-Vessel Involvement.
СтатьяНазвание и аннотация: Перевод в очереди
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Orvain Thibault, Samson Maxime, Dumont Anael, Boutemy Jonathan, Daumas Aurélie, Delacotte Claire, Deshayes Samuel, Espitia Olivier, Gallou Sophie, Pinho Quentin Gomes De, Hankard Antoine, Ly Kim Heang, Maigné Gwénola, Silva Nicolas Martin, Perard Laurent, Philip Rémi, Trenec Marine, Aouba Achille, de Boysson Hubert, French study group for large vessel vasculitis (GEFA)
Аннотация
OBJECTIVES: To evaluate the proportion of patients with giant cell arteritis (GCA)-related large-vessel involvement (LVI) with a complete metabolic remission on PET/CT after treatment with glucocorticoids (GC) only.
METHODS: This retrospective multicenter cohort enrolled GCA patients with LVI diagnosed on PET/CT. Each patient underwent at least a second PET/CT >3 months after the first procedure and was treated only with GC. Our primary endpoint was the proportion of patients with complete metabolic remission on the second PET/CT.
RESULTS: Among the 75 enrolled patients, 32 (43%) showed a complete metabolic remission at last follow-up. The second PET/CT was performed 8 [5-11] months after the initial PET/CT. Among the 32 patients, 16 were weaned off GC with a follow-up >12 months after the negative PET/CT. Among the 43 patients without metabolic remission, 19 showed stable or increased vascular uptake at follow-up, and 24 had persistent PET/CT positivity with fewer involved vascular territories. At last follow-up (median: 51 [27-93] months), 66 and 56% of patients with and without metabolic remission, respectively, had discontinued GC. Two patients showed LVI relapse on a third PET/CT. Of the 34 patients with available data regarding aorta morphology during follow-up, 8 developed an aortic dilation, and all of them had persistent positive PET/CT (log-rank: p < 0.05).
CONCLUSION: A complete metabolic remission on PET/CT was observed in 43% of GCA patients with LVI treated with GC alone. Aortic dilation exclusively occurred in patients with persistent positive PET/CT.
METHODS: This retrospective multicenter cohort enrolled GCA patients with LVI diagnosed on PET/CT. Each patient underwent at least a second PET/CT >3 months after the first procedure and was treated only with GC. Our primary endpoint was the proportion of patients with complete metabolic remission on the second PET/CT.
RESULTS: Among the 75 enrolled patients, 32 (43%) showed a complete metabolic remission at last follow-up. The second PET/CT was performed 8 [5-11] months after the initial PET/CT. Among the 32 patients, 16 were weaned off GC with a follow-up >12 months after the negative PET/CT. Among the 43 patients without metabolic remission, 19 showed stable or increased vascular uptake at follow-up, and 24 had persistent PET/CT positivity with fewer involved vascular territories. At last follow-up (median: 51 [27-93] months), 66 and 56% of patients with and without metabolic remission, respectively, had discontinued GC. Two patients showed LVI relapse on a third PET/CT. Of the 34 patients with available data regarding aorta morphology during follow-up, 8 developed an aortic dilation, and all of them had persistent positive PET/CT (log-rank: p < 0.05).
CONCLUSION: A complete metabolic remission on PET/CT was observed in 43% of GCA patients with LVI treated with GC alone. Aortic dilation exclusively occurred in patients with persistent positive PET/CT.