title: Long-term remission in biopsy proven giant cell arteritis: A retrospective cohort study.
abstract: To evaluate the frequency of long-term remission after glucocorticoids (GCs) suspension in an Italian cohort of patients with biopsy-proven GCA and to identify factors that may predict long-term remission.
  
  
  
  We evaluated 131 patients with biopsy-proven transmural GCA diagnosed and followed up at the Rheumatology Unit of Reggio Emilia Hospital (Italy) for whom sufficient information was available from the time of diagnosis until at least 18 months of follow-up. Long-term remission was defined as complete clinical remission without elevation of inflammatory markers for at least one year after the GC withdrawal.
  
  
  
  73 patients (56%) experienced long-term remission. Disease flares were less frequently observed in patients with long-term remission compared to those without (p = 0.002). The cumulative doses of prednisone at 1 year and for the entire followup duration were significantly lower (p < 0.0001 for both parameters) in patients with long-term remission; similarly, the duration of prednisone treatment was also significantly lower (p < 0.0001). The presence of PMR at diagnosis (HR 0.46) was significantly negatively associated with long-term remission (p = 0.008), while hemoglobin levels (HR 1.48) were significantly positively associated (p < 0.0001). Patients with long-term remission were able to reach 10 mg/day and 5 mg/day of prednisone sooner than the patients without (p = 0.02 and p < 0.0001, respectively).
  
  
  
  In our cohort of GCA patients around half of the patients were able to attain long-term remission. Recognition of findings which predict disease course may aid decisions regarding therapy.
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Restuccia
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Boiardi
authors.affiliation: Operative Unit of Pathologic Anatomy, Department of Oncology and Advanced Technology, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Cavazza
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Mariagrazia
authors.initials: M
authors.lastname: Catanoso
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Macchioni
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Muratore
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Soriano
authors.affiliation: Ophthalmology Unit, Department of Surgery, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Cimino
authors.affiliation: Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Aldigeri
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Crescentini
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: Pipitone
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy. Electronic address: salvarani.carlo@asmn.re.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Salvarani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D001706:Biopsy; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D063189:Symptom Assessment
chemical_list: D015415:Biomarkers; D005938:Glucocorticoids
keywords: Corticosteroids; Giant cell arteritis; Polymyalgia rheumatica; Treatment