Efficacy of Methotrexate in Real-world Management of Giant Cell Arteritis: A Case-control Study
| dc.contributor.author | Koster, Matthew | |
| dc.contributor.author | Yeruva, Karthik | |
| dc.contributor.author | Crowson, Cynthia S. | |
| dc.contributor.author | Muratore, Francesco | |
| dc.contributor.author | Labarca, Cristian | |
| dc.contributor.author | Warrington, Kenneth J. | |
| dc.date.accessioned | 2022-07-07T16:24:55Z | |
| dc.date.available | 2022-07-07T16:24:55Z | |
| dc.date.issued | 2019 | |
| dc.description.abstract | Objective: To determine the effect of methotrexate (MTX) on relapse risk and glucocorticoid (GC) use in a large single-institution cohort of patients with giant cell arteritis (GCA). Methods: Patients diagnosed with GCA from 1998 to 2013 with confirmed evidence of temporal artery biopsy and/or radiographic evidence of large vessel vasculitis were identified. Each patient with GCA treated with adjunct MTX (case) was matched to a similar patient with GCA treated only with GC (control). GC requirements and relapse events before and after MTX initiation (or corresponding index date) were compared using rate ratios (RR). Results: Eighty-three cases and 83 controls were identified and compared. No significant differences in age, demographics, laboratory variables, baseline disease characteristics, or mean initial prednisone doses were observed. Median [interquartile range (IQR)] time from GCA diagnosis to MTX initiation in cases was 39 (13-80) weeks and the median (IQR) starting dose was 13.5 (10-15) mg/week. RR comparing relapse rates before and after MTX initiation/index date were significantly reduced in both cases (RR 0.32, 95% CI 0.24-0.41) and controls (RR 0.60, 95% CI 0.43-0.86). The decrease in relapse rate was significantly greater in patients taking MTX than in those taking GC alone (p = 0.004). Rates of GC discontinuation did not differ between groups. Conclusion: In this large single-institution cohort, the addition of MTX to GC decreased the rate of subsequent relapse by nearly 2-fold compared to patients taking GC alone. MTX may be considered as adjunct therapy in patients with GCA to decrease the risk of further relapse events. | es |
| dc.description.version | Versión Publicada | es |
| dc.identifier.citation | Koster MJ, Yeruva K, Crowson CS, Muratore F, Labarca C, Warrington KJ. Efficacy of Methotrexate in Real-world Management of Giant Cell Arteritis: A Case-control Study. J Rheumatol. 2019 May;46(5):501-508. doi: 10.3899/jrheum.180429. | es |
| dc.identifier.uri | https://doi.org/10.3899/jrheum.180429 | es |
| dc.identifier.uri | http://hdl.handle.net/11447/6320 | |
| dc.language.iso | en | es |
| dc.subject | Giant cell arteritis | es |
| dc.subject | Glucorticoids | es |
| dc.subject | Methotrexate | es |
| dc.subject | Relapse | es |
| dc.subject | Vasculitis | es |
| dc.title | Efficacy of Methotrexate in Real-world Management of Giant Cell Arteritis: A Case-control Study | es |
| dc.type | Article | es |
| dcterms.source | The Journal of Rheumatology | es |