POS0806 FINDINGS CONSISTENT WITH SUBCLINICAL VASCULITIS IN PATIENTS WITH NEW ONSET POLYMYALGIA: A SYSTEMATIC LITERATURE REVIEW AND A META-ANALYSIS OF COHORT DATA
نویسندگان
چکیده
Background: GCA is characterized by cranial symptoms but imaging techniques show that patients with non-specific such as systemic inflammation or PMR may have undiagnosed large vessel (LV) 1 . Although silent in clinically isolated consequences for patients’ outcome, little known about its prevalence and characteristics of affected patients. Objectives: To review data on the newly diagnosed without to analyze which are associated vascular involvement among Methods: We systematically screened PubMed, Embase Web Science databases included studies screening steroid naïve consistent GCA. Authors publications used PET vasculitis were invited share their individual patient (IPD) a meta-analysis. sought define using univariable mixed effects logistic regression models missing values imputed multilevel joint modeling multiple imputation. fit multivariable model candidate predictors we excluded variables hypothesized less medical relevance outcome highly correlated markers (ESR, Lc). Results: Out 3047 independently 2 authors (DG TD), 13 fulfilled inclusion criteria. These (published 1963-2019) reported 543 examined temporal artery biopsy (n=175), ultrasound (n=110), PET-CT (n=258). 115 (21.2%), ranging from 0-92%. collected IPD 243 4 cohorts 3 PET/CT diagnosis. The overall median age was 72.3 years (IQR 66.4-78.0) found 65 (26.7%) (table 1). Table 1. Overall PMR+GCA n (%) 178 (73.3) (26.7) Female sex 146 (60.1) 98 (55.1) 48 (73.8) Shoulder girdle pain 236 (97.1) 174 (97.8) 62 (95.4) Pelvic (71.6) 127 (71.3) 47 (72.3) Inflammatory back No 107 (44.0) 83 (46.6) 24 (36.9) Yes 106 (43.6) 70 (39.3) 36 (55.4) Lower limb 87 (35.8) 61 (34.3) 26 (40.0) 81 (33.3) 68 (38.2) (20.0) Weight loss 112 (46.1) 78 (43.8) 34 (52.3) CRP (mg/l) (median [IQR]) 46.0 [19.0, 77.7] 44.0 [16.9, 74.2] 52.0 [27.9, 85.0] ESR (mm/h) (mean (SD)) 65.2 (30.3) 62.7 (30.2) (29.7) Hemoglobin (g/dl) 12.1 (1.5) 12.2 11.7 (1.6) Thrombocytes (1e+09/ml) 341.9 (106.3) 323.9 (103.2) 375.8 (104.6) In analyses following factors most strongly vasculitic findings: female (OR 2.31, CI 1.17-4.58), inflammatory 2.73, 1.32-5.64), temperature >37° 1.83, 0.90-3.7), weight 0.96-3.51), thrombocytosis (i.e., thrombocyte count SD above mean an OR 1.51, 1.05-2.18), anemia g/dl decrease Hb below corresponds 1.25, 1.00-1.56). Patients lower likely 0.43, 0.19–0.95). estimated ORs very similar although 95%CIs became wider. Conclusion: across published showed substantial variation, 6 out 18-40% all exploratory analysis identified sex, pain, fever, loss, absence leg LV-GCA. findings should be validated future prospective cohort studies. presence these further aid diagnosing LV-GCA References: [1]Buttgereit F, Dejaco C, Matteson EL, Dasgupta B. Polymyalgia Rheumatica Giant Cell Arteritis: A Systematic Review. JAMA. 2016 Jun 14;315(22):2442–58. Acknowledgements: study funded “Schweizerische Stiftung für die Erforschung der Muskelkrankheiten (SSEM)”. Disclosure Interests: Daniele Silvio Gozzoli: None declared, Andrea Hemmig: Lars Hemkens: Laura Werlen: Hannah Ewald: Christoph Berger: Diego Kyburz Grant/research support from: DK reports personal fees Abbvie, Gilead, Lilly, Novartis Pfizer, outside submitted work, Stephan Imfeld: Markus Aschwanden: Mihaela Stegert: Dario Camellino: Marco Amedeo Cimmino: Corrado Campochiaro Roche, Alessandro Tomelleri: Liesbet Henckaerts: Daniel Blockmans Speakers bureau: Paid speaker Consultant of: consultant Patricia Moya: Hector Corominas: Russell Buchanan: Claire Owen CO has received speaking honoraria Janssen, meeting sponsorship UCB Yannick van Sleen: Elisabeth Brouwer E. employee UMCG consulting Roche 2017, 2018 paid UMCG, Hiroyuki Ymashita: Thomas Daikeler: declared
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ژورنال
عنوان ژورنال: Annals of the Rheumatic Diseases
سال: 2021
ISSN: ['1468-2060', '0003-4967']
DOI: https://doi.org/10.1136/annrheumdis-2021-eular.1803