Incidence and prevalence of large vessel vasculitis (giant cell arteritis and Takayasu arteritis) in northern Italy: A population-based study

Muratore, Francesco; Boiardi, Luigi; Mancuso, Pamela; Restuccia, Giovanna; Galli, Elena; Marvisi, Chiara; Macchioni, Pierluigi; Rossi, Paolo; Salvarani, Carlo

doi:10.1016/j.semarthrit.2021.06.001

Cited by 20 publications

(21 citation statements)

References 33 publications

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“…We do recognize the potential bias inherent in an online survey. In addition, there seems to be a bias toward patients with small-vessel vasculitis, as this disease is less common than large-vessel vasculitis in the general population ( 35 , 36 ), but more prevalent in our cohort. This also explains the large proportion of patients reporting a therapy with rituximab, which is used as one standard therapy in ANCA-associated vasculitis.…”

Section: Discussionmentioning

confidence: 78%

COVID-19 pandemic impairs medical care of vasculitis patients in Germany: Results of a national patient survey

et al. 2023

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ObjectiveTo analyze the impact of the COVID-19 pandemic on medical care and vaccination acceptance of vasculitis patients in Germany.MethodsA web-based national survey was developed by rheumatology centers and vasculitis patient advocacy groups. The survey was distributed nationwide by mail and flyers and could be accessed via a QR-code or weblink from December 2021 to April 2022. Descriptive statistics [mean, median, standard derivation (SD), 25%, 75% quantile] were calculated. 95% confidence intervals were presented for responses that were directly related to the impact of COVID-19 on parameters associated with vasculitis patient care.ResultsThe online survey was completed by 117 patients with small and large vessel vasculitis [granulomatosis with polyangiitis (n = 69), eosinophilic granulomatosis with polyangiitis (n = 16), microscopic polyangiitis (n = 12), giant cell arteritis (n = 17) and Takayasu's arteritis (n = 3)]. Prescheduled rheumatological appointments had been canceled due to the COVID-19 pandemic in 12.6% of the respondents [95% confidence interval (CI), 7.3–20.0%); in 9% (95% CI, 4.5–15.6%)] appointments had been replaced by digital services. Therapeutic regimens were changed (shifted, reduced, or discontinued) due to the pandemic in 15.5% (95% CI 9.5–22.2%). Vaccination coverages were generally high compared to patients with other rheumatic diseases and the general population. Highest vaccination coverage was observed against COVID-19 (98.1% 95% CI 93.9–99.6%).ConclusionVasculitis patients experienced changes in medical care during COVID-19 pandemic such as cancelation of prescheduled rheumatology appointments and modifications in therapeutic regimens. The overall acceptance rate for vaccination was comparatively high, particularly for vaccination against COVID-19.

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Section: Discussionmentioning

confidence: 78%

COVID-19 pandemic impairs medical care of vasculitis patients in Germany: Results of a national patient survey

et al. 2023

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“…The concept of the heterogeneity of GCA with different subsets characterized by different clinical manifestations is widely accepted [21][22][23][24]. At one end of the spectrum there are patients with temporal artery involvement with prevalent cranial manifestations, while at the other end there are patients with large vessel involvement with prevalent systemic manifestations and polymyalgic symptoms; patients with overlapping features stay in the middle [21,24].…”

Section: Discussionmentioning

confidence: 99%

The role of PET/CT in disease activity assessment in patients with large vessel vasculitis

Galli

Pipitone

Salvarani

2023

Current Opinion in Rheumatology

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Objectives. To evaluate the accuracy of PET/CT and of PET vascular activity score (PETVAS) in assessing disease activity and the ability of PETVAS in predicting relapses in a large single-centre cohort of patients with large vessel vasculitis (LVV).Methods. We conducted a retrospective cohort study of prospectively collected data of consecutive patients diagnosed with LVV who underwent at least one PET/CT scan between 2007 and 2020. The nuclear medicine physician's interpretation of each PET/CT scan (active/inactive vasculitis) was compared with disease activity clinical judgement (active disease/remission). For each PET/CT scan, the PETVAS score was calculated and its accuracy in assessing disease activity was evaluated. The ability of PETVAS in predicting subsequent relapses was evaluated.Results. A total of 100 consecutive LVV patients (51 large vessel GCA, 49 Takayasu arteritis) underwent a total of 476 PET/CT scans over a mean follow-up period of 97.5 months. Physician-determined PET/CT grading was able to distinguish between clinically active and inactive LVV with a sensitivity of 60% (95% CI 50.9, 68.7) and specificity of 80.1% (95% CI 75.5, 84.1); the area under the curve (AUC )was 0.70 (95% CI 0.65, 0.75). PETVAS was associated with disease activity, with an age and sex-adjusted odds ratio for active disease of 1.15 (95% CI 1.11, 1.19). A PETVAS 10 provided 60.8% sensitivity and 80.6% specificity in differentiating between clinically active and inactive LVV; the AUC was 0.73 (95% CI 0.68, 0.79). PETVAS was not associated with subsequent relapses, with an age and sex-adjusted hazard ratio of 1.04 (95% CI 0.97, 1.11).Conclusions. The visual PET/CT grading scale and PETVAS had moderate accuracy to distinguish active LVV from remission. PETVAS did not predict disease relapses.

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“…This is a retrospective cohort study on prospectively collected data of consecutive patients diagnosed with LVV who were referred to the Rheumatology Unit of the Santa Maria Nuova Hospital of Reggio Emilia (northern Italy) between 2007 and 2020. All patients satisfied the modified inclusion criteria of the GiACTA trial for GCA, 18 and the 1990 American College of Rheumatology classification criteria for TAK 19 ; the diagnosis of LVV, confirmed by imaging, was defined as the presence of circumferential wall thickening/oedema with or without contrast enhancement and/or the presence of vascular stenosis/occlusion and/or dilation/aneurysm on CTA or MRA and/or the presence of vascular uptake on PET-CT. Patients under the age of 50 years at symptom onset were classified as TAK and those over 50 years as GCA.…”

Section: Methodsmentioning

confidence: 99%

Vessel inflammation and morphological changes in patients with large vessel vasculitis: a retrospective study

et al. 2022

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ObjectiveThe aim was to identify any association between imaging signs of vessel wall inflammation (positron emission tomography–CT (PET-CT) score and CT/MR wall thickening) and synchronous and subsequent vascular damage (stenoses/dilations) in patients with large vessel vasculitis (LVV).MethodsConsecutive patients with LVV referred to a tertiary centre in 2007–2020 with baseline PET-CT and morphological imaging (CT/MR angiography) performed within 3 months were included. All available PET-CT and CT/MR scans were reviewed to assess PET-CT uptake (4-point semi-quantitative score), wall thickening, stenoses and dilations for 15 vascular segments. The associations of baseline PET score and CT/MR wall thickening with synchronous and incident stenoses/dilations at CT/MR performed 6–30 months from baseline were evaluated in per-segment and per-patient analyses. Respective areas under the receiver operating characteristic curve (AUC) were calculated.ResultsWe included 100 patients with LVV (median age: 48 years, 22% males). Baseline PET score and wall thickening were strongly associated (Cuzick non-parametric test for trend across order groups (NPtrend) <0.001). The association with synchronous stenoses/dilations was weak for PET score (NPtrend=0.01) and strong for wall thickening (p<0.001). In per-patient analyses, sensitivity/specificity for ≥1 synchronous stenoses/dilations were 44%/67% for PET score ≥2 and 66.7%/60.5% for wall thickening. Subsequent CTs/MRs were available in 28 patients, with seven incident stenoses/dilations. Baseline PET score was strongly associated with incident stenoses/dilations (p=0.001), while baseline wall thickening was not (p=0.708), with AUCs for incident stenoses/dilations of 0.80 for PET score and 0.52 for wall thickening.ConclusionPET score and wall thickening are strongly associated, but only baseline PET score is a good predictor of incident vessel wall damage in LVV.

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Incidence and prevalence of large vessel vasculitis (giant cell arteritis and Takayasu arteritis) in northern Italy: A population-based study

Cited by 20 publications

References 33 publications

COVID-19 pandemic impairs medical care of vasculitis patients in Germany: Results of a national patient survey

COVID-19 pandemic impairs medical care of vasculitis patients in Germany: Results of a national patient survey

The role of PET/CT in disease activity assessment in patients with large vessel vasculitis

Vessel inflammation and morphological changes in patients with large vessel vasculitis: a retrospective study

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