Prognosis of large-vessel giant cell arteritis

Rheumatology (Oxford). 2008 Sep;47(9):1406-8. doi: 10.1093/rheumatology/ken258. Epub 2008 Jul 14.


Objective: The prognosis of large-vessel GCA (LV-GCA) has not yet been investigated. How does it compare to GCA without arm vasculitis (GCA controls)?

Methods: Charts of 53 LV-GCA patients and 53 GCA controls were reviewed following a predetermined protocol. Telephone interviews of patients or their primary care physicians were conducted. Forty LV-GCA patients underwent follow-up duplex ultrasound examinations of proximal arm arteries.

Results: The mean observation time was 50 (s.d. +/- 31) months. None of the LV-GCA patients developed ischaemic arm complications. In 30%, proximal arm artery wall swelling disappeared completely. It decreased in 53%. In 8% it remained unchanged, in 5% it increased and in 5% arteries occluded with collateral flow. After the start of treatment, anterior ischaemic optic neuropathy developed neither in LV-GCA patients nor in GCA controls, amaurosis fugax occurred in 4 and 6%, arterial hypertension in 53 and 66%, strokes in 9 and 9%, myocardial infarction in 2 and 2%, diabetes mellitus in 30 and 25%, osteoporosis in 38 and 23%, and osteoporotic fractures in 15 and 4%, respectively. Mean corticosteroid dose was 3.7 mg/day. Mean duration of therapy was 42 months. All differences were insignificant. Four LV-GCA patients developed vasculitic popliteal artery stenoses.

Conclusions: The prognosis of LV-GCA is benign with regard to ischaemic complications. Proximal artery wall swelling decreases in most cases. Its course is similar to GCA without proximal arm arteritis.

MeSH terms

  • Aged
  • Arm / blood supply*
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / etiology
  • Female
  • Follow-Up Studies
  • Giant Cell Arteritis / complications*
  • Giant Cell Arteritis / diagnosis*
  • Giant Cell Arteritis / diagnostic imaging
  • Humans
  • Ischemia / diagnostic imaging
  • Ischemia / etiology*
  • Male
  • Middle Aged
  • Peripheral Vascular Diseases / diagnostic imaging
  • Peripheral Vascular Diseases / etiology*
  • Prognosis
  • Ultrasonography, Doppler, Color