Prognostic value of quantifying vascular inflammation through ultrasound in patients with giant cell arteritis: the MAGiCUS study.
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Molina-Collada Juan, Cowley Sharon, Kirby Colm, Kane David, Harkins Patricia, Conway Richard, Castrejón Isabel, Álvaro-Gracia José María, Ponte Cristina, Monti Sara, Milanesi Alessandra, Conticini Edoardo, Placido Francesco, El Miedany Yasser, Monjo-Henry Irene, Padoan Roberto, Iorio Luca, Macchioni Pierluigi, Salvarani Carlo, Estrada Paula, Camacho Óscar, Karalilova Rositsa, Blanco Boris, Moragues Carmen, Bond Milena, Prieto Peña Diana, Sánchez Julio, de Agustín Juan Jose, Santamaría Pablo Castro, Mera Varela Antonio, Calvo-Aranda Enrique, Quick Vanessa, González Navarro Pablo, Vellosillo González Perceval, Dejaco Christian, de Miguel Eugenio, MAGiCUS Project Collaborative Group
Аннотация
METHODS: The Monitoring Activity of GCA through UltraSound (MAGiCUS) project is an international, multicentre, prospective, observational study including newly diagnosed GCA patients. Ultrasound of temporal and axillary arteries was conducted at baseline, 1, 3, 6 and 12 months. Vascular inflammation was quantified using the OMERACT GCA Ultrasonographic Score (OGUS). The primary outcome was the occurrence of the first clinical relapse between 6 and 12 months.
RESULTS: Among 156 GCA patients from 19 centres, 31 (19.9%) experienced a relapse. In patients without a relapse, OGUS was significantly lower at all follow-up visits than baseline (-0.15 to -0.35). Baseline OGUS was significantly higher in relapsing patients (1.58 vs 1.16, P < 0.001). In multivariate analysis, an increase in 0.1 units in baseline OGUS was associated with relapse (odds ratio [OR] 1.19; 95% CI: 1.08, 1.34). This association remained significant for 0.1 increases in OGUS at 1 month (OR 1.37; 95% CI: 1.17, 1.66) and at 3 months (OR 1.51; 95% CI: 1.20, 1.98). The areas under the receiver operating characteristic curve for predicting relapse were 0.70 (95% CI: 0.58, 0.80) for baseline OGUS, 0.74 (95% CI: 0.60, 0.85) at 1 month, and 0.67 (95% CI: 0.56, 0.78) at 3 months.
CONCLUSION: Ultrasound-based quantification of vascular inflammation has prognostic value for predicting relapses during follow-up in GCA. Higher baseline, 1-month and 3-months OGUS are associated with an increased probability of clinical relapse.