title: Glucocorticoid usage in giant cell arteritis over six decades (1950 to 2009).
abstract: OBJECTIVE
  To evaluate the trends in glucocorticoid (GC) therapy in patients with giant cell arteritis (GCA).
  
  
  METHODS
  Using a population-based inception cohort, GC therapy details were collected for all patients with GCA diagnosed between 1950-2009. GC usage for patients diagnosed with GCA between 1980-2009 was compared to those diagnosed between 1950-1979.
  
  
  RESULTS
  The mean starting dose was similar in both time-periods but the mean cumulative dosages at different time points were significantly higher for patients diagnosed between 1980-2009 than in 1950-1979 (at 1-year: 6.3 vs. 4.1g; and at 5 years 10.7 vs. 7.6g, respectively, p<0.001). The median time to permanent discontinuation of GC was 2.6 years for 1980-2009 vs. 1.5 years for 1950-1979 (p=0.004). The risk for GC-associated adverse events was similar in both time periods (p=0.52).
  
  
  CONCLUSIONS
  GCA patients diagnosed in the last three decades were treated with higher cumulative GC doses and were less likely to achieve GC discontinuation. However, their risks for GC-related complications were not significantly higher than their earlier counterparts.
authors.affiliation: Division of Rheumatology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors.forename: A
authors.initials: A
authors.lastname: Chandran
authors.affiliation: Division of Rheumatology, Department of Medicine, Mayo Clinic College of Medicine, Rochester; and Division of Rheumatology, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Pr D
authors.initials: PD
authors.lastname: Udayakumar
authors.affiliation: Division of Rheumatology, University of California, Los Angeles, CA, USA.
authors.forename: T A
authors.initials: TA
authors.lastname: Kermani
authors.affiliation: Division of Rheumatology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors.forename: K J
authors.initials: KJ
authors.lastname: Warrington
authors.affiliation: Division of Rheumatology, Department of Medicine; and Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors.forename: C S
authors.initials: CS
authors.lastname: Crowson
authors.affiliation: Division of Rheumatology, Department of Medicine; and Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors.forename: E L
authors.initials: EL
authors.lastname: Matteson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D013700:Giant Cell Arteritis / Q000188:drug therapy*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012189:Retrospective Studies
chemical_list: D005938:Glucocorticoids