[Treatment of Horton disease. Value of synthetic antimalarials. Apropos of a retrospective study of 36 patients].
Thirty-six patients with giant cells arteritis were studied retrospectively. Histological examination of the temporal artery or another artery was positive in 95% of cases. Mean follow-up was five years. A synthetic antimalarial was used in every case. Two groups were differentiated. One (Group I) was composed of 21 patients who were given the antimalarial drug as part of the first-line therapy, either with a corticosteroid in a mean dose of 36 mg/d (18 patients) or with a nonsteroidal antiinflammatory agent. The other group (Group II) included 15 patients in whom the antimalarial was used after a period of corticosteroid therapy, because of steroid-dependency (n = 5) or adverse effects (n = 9), or as part of a routinely used protocol (n = 1). Withdrawal of the corticosteroid was achieved in 81% of cases, after a mean interval of 15 months. Many patients discontinued the corticosteroid after less than one year. The 18 Group I patients who were given a corticosteroid were all able to discontinue this drug. The overall recovery rate was 58%; mean time to recovery was 33 months with a mean follow-up of 52 months. There were no recurrences at discontinuation of the treatment. Adverse effects of antimalarial therapy were recorded in 30.5% of patients and required discontinuation of the drug in 19%. The most often used regimen was hydroxychloroquine (40 mg/d) for at least two years and prednisone 20 to 30 mg/d for two months, in the absence of vascular complications.(ABSTRACT TRUNCATED AT 250 WORDS)
Le Guennec
P
P
Service de Clinique de Rhumatologie, Centre Hospitalier Universitaire- Hôpital de Purpan, Toulouse.
Dromer
C
C
Sixou
L
L
Marc
V
V
Coustals
P
P
Fournié
B
B
D000368:Aged; D000369:Aged, 80 and over; D000962:Antimalarials / Q000627:therapeutic use*; D005260:Female; D013700:Giant Cell Arteritis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies
D000962:Antimalarials; D011241:Prednisone
Traitement de la maladie de Horton. Intérêt des antipaludéens de synthèse. A propos d'une série rétrospective de 36 patients.