Efficacy and tolerance of methotrexate in a real-life monocentric cohort of patients with giant cell arteritis
Copyright © 2023. Published by Elsevier Inc..
OBJECTIVES: To assess the indications, efficiency and tolerance profiles of methotrexate (MTX) in patients with giant cell arteritis (GCA) in a real-life setting.
METHODS: From a monocentric database of >500 GCA patients, we retrospectively selected 49 patients who received MTX between 2010 and 2020. Cumulative glucocorticoid (GC) doses, the number of relapses and GC-related adverse events were recorded before, during and after MTX. We separately analyzed the 3 main indications of MTX, i.e., disease relapse, GC-sparing strategy, and GCA presentation.
RESULTS: With a median follow-up of 84 [10-255] months, 25 (51%) and 18/41 (44%) patients relapsed during MTX treatment and after its discontinuation, respectively. Among the 40 patients who relapsed before MTX, 26 (65%) experienced a new relapse after MTX introduction. Once MTX was introduced, 24 (49%) patients were able to discontinue GC after 20.5 [7-64] months. No significant difference in cumulative GC doses were noted before and after MTX introduction with a total GC dose of 14.7 [1.05-69.4] grams. At the last follow-up, MTX was discontinued in 41 patients, including 13 (32%) due to clinicobiological remission, 12 (30%) due to treatment failure and 15 (36%) due to side effects.
CONCLUSION: Our real-life study showed a modest beneficial effect of MTX on relapse in patients with GCA. However, we did not observe any GC-sparing effect in this study. Other studies are needed to assess the GC-sparing effect in patients in whom GC management is adapted from recent recommendations.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:60 |
|---|---|
| Enthalten in: |
Seminars in arthritis and rheumatism - 60(2023) vom: 01. Juni, Seite 152192 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Lavergne, Amandine [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Adverse events |
|---|
| Anmerkungen: |
Date Completed 01.05.2023 Date Revised 02.05.2023 published: Print-Electronic ClinicalTrials.gov: NCT03892785 Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.semarthrit.2023.152192 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM354682571 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM354682571 | ||
| 003 | DE-627 | ||
| 005 | 20231226062736.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.semarthrit.2023.152192 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1182.xml |
| 035 | |a (DE-627)NLM354682571 | ||
| 035 | |a (NLM)36963127 | ||
| 035 | |a (PII)S0049-0172(23)00032-X | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Lavergne, Amandine |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Efficacy and tolerance of methotrexate in a real-life monocentric cohort of patients with giant cell arteritis |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 01.05.2023 | ||
| 500 | |a Date Revised 02.05.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT03892785 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023. Published by Elsevier Inc. | ||
| 520 | |a OBJECTIVES: To assess the indications, efficiency and tolerance profiles of methotrexate (MTX) in patients with giant cell arteritis (GCA) in a real-life setting | ||
| 520 | |a METHODS: From a monocentric database of >500 GCA patients, we retrospectively selected 49 patients who received MTX between 2010 and 2020. Cumulative glucocorticoid (GC) doses, the number of relapses and GC-related adverse events were recorded before, during and after MTX. We separately analyzed the 3 main indications of MTX, i.e., disease relapse, GC-sparing strategy, and GCA presentation | ||
| 520 | |a RESULTS: With a median follow-up of 84 [10-255] months, 25 (51%) and 18/41 (44%) patients relapsed during MTX treatment and after its discontinuation, respectively. Among the 40 patients who relapsed before MTX, 26 (65%) experienced a new relapse after MTX introduction. Once MTX was introduced, 24 (49%) patients were able to discontinue GC after 20.5 [7-64] months. No significant difference in cumulative GC doses were noted before and after MTX introduction with a total GC dose of 14.7 [1.05-69.4] grams. At the last follow-up, MTX was discontinued in 41 patients, including 13 (32%) due to clinicobiological remission, 12 (30%) due to treatment failure and 15 (36%) due to side effects | ||
| 520 | |a CONCLUSION: Our real-life study showed a modest beneficial effect of MTX on relapse in patients with GCA. However, we did not observe any GC-sparing effect in this study. Other studies are needed to assess the GC-sparing effect in patients in whom GC management is adapted from recent recommendations | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Adverse events | |
| 650 | 4 | |a Cumulative glucocorticoid doses | |
| 650 | 4 | |a Giant cell arteritis | |
| 650 | 4 | |a Glucocorticoids | |
| 650 | 4 | |a Glucocorticoids sparing effect | |
| 650 | 4 | |a Methotrexate | |
| 650 | 4 | |a Relapse | |
| 650 | 7 | |a Methotrexate |2 NLM | |
| 650 | 7 | |a YL5FZ2Y5U1 |2 NLM | |
| 650 | 7 | |a Glucocorticoids |2 NLM | |
| 700 | 1 | |a Dumont, Anael |e verfasserin |4 aut | |
| 700 | 1 | |a Deshayes, Samuel |e verfasserin |4 aut | |
| 700 | 1 | |a Boutemy, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a Maigné, Gwénola |e verfasserin |4 aut | |
| 700 | 1 | |a Silva, Nicolas Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Nguyen, Alexandre |e verfasserin |4 aut | |
| 700 | 1 | |a Gallou, Sophie |e verfasserin |4 aut | |
| 700 | 1 | |a Philip, Rémi |e verfasserin |4 aut | |
| 700 | 1 | |a Aouba, Achille |e verfasserin |4 aut | |
| 700 | 1 | |a de Boysson, Hubert |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Seminars in arthritis and rheumatism |d 1971 |g 60(2023) vom: 01. Juni, Seite 152192 |w (DE-627)NLM000215643 |x 1532-866X |7 nnns |
| 773 | 1 | 8 | |g volume:60 |g year:2023 |g day:01 |g month:06 |g pages:152192 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.semarthrit.2023.152192 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 60 |j 2023 |b 01 |c 06 |h 152192 | ||