The aim of this national pragmatic observational study is to investigate whether the use of new diagnostic imaging modalities facilitates disease stratification that can potentially predict treatment response, relapse risk and complications and hence guide management strategies to improve disease control and reduce disease and treatment related damage.
BACKGROUND Giant cell arteritis (GCA) is the most common vasculitis of the elderly. The concomitant disease polymyalgia rheumatica (PMR) is characterised by pain of the proximal muscles, general symptoms, and raised inflammatory markers. Only limited research has previously been performed nationally and internationally in GCA and PMR. To explore clinical practice, biomarkers, disease subsets, comorbidities, and long-term effectiveness of new treatments the establishment of large registries are highly warranted. OBJECTIVES Primary objective: To compare cumulative GC doses in patients with c-GCA as compared to Large vessel (LV) -GCA Key secondary objectives: 1. To compare cumulative GC doses in patients with pure PMR compared to PMR patients with subclinical LV-GCA 2. To compare the incidence of aortic dilatation 2 years after diagnosis in patients with c-GCA as compared to LV-GCA 3. In the subpopulation of patients whom a diagnostic Fluor-Deoxy-Glucose Positron Emissions Tomography ( FDG- PET)/CT was performed, to evaluate the risk of aortic complications (aneurisms and dissections) in GCA patients with aortic involvement as compared to patients without aortic involvement. Once the database is established nationally, the database will be the basis for additional research projects in the future. METHODS Using RedCap database infrastructure, clinical data including imaging will be documented in the individual Case Report Form developed by the project steering group. The study population can be enrolled at any point during disease course and registered as either incidents ( up until 3 months from diagnosis) or prevalent. The treatment and follow up will be performed according to the National Danish GCA and PMR guidelines. At some of the visits data entry to the database will be performed: Enrollment visit, response visit(after 2 months), routine visit(after 6 months for incident patients and every year following), screening visit(2 years after diagnosis) and withdrawal visits. The aim is to include all rheumatic departments in Denmark. Data audit to secure a high completeness will be performed regularly by a project manager the first two years and thereafter by a datamanager. Linkage of data across nationwide medical and administrative registries at the individual level will be performed. Blood samples will be collected by the infrastructure of the clinical biobank Danish ReumaBiobank (DRB).
Study Type
OBSERVATIONAL
Enrollment
3,000
Led og Bindevævssygdomme, Aarhus University Hospital
Aarhus, Denmark
RECRUITINGMedicinsk klinik 2, Regionshospitalet Horsens
Horsens, Denmark
RECRUITINGCumulative glucocorticoid doses compared between patients with cranial GCA and patients with Large Vessel-GCA
based on redeemed prescriptions
Time frame: From date of diagnosis with GCA until one year after. Assessed yearly up to 120 months
Comparison of cumulative glucocorticoid doses in patients with pure PMR compared to PMR with subclinical LV-GCA
based on redeemed prescriptions
Time frame: From date of diagnosis with PMR until one year after. Assessed yearly up to 120 months
Incidence of aortic dilatation in patients with c-GCA as compared to LV-GCA
Aortic dilatation is defined as diameters above the 90th percentile of the respective aortic region.The angiography can be performed as either CT or MR angiography and will be performed according to local set-up and imaging acquisition protocols.
Time frame: 2 years after diagnosis
Risk of aortic complications (aneurisms and dissections) in GCA patients with aortic involvement as compared to patients without aortic involvement.
The PET/CT scan at diagnosis compared to scan at year 2
Time frame: 2 years after diagnosis
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