Glucocorticoids are commonly used to treat giant cell arteritis but these drugs come with serious adverse effects when taken for long periods.This study examined glucocorticoid usage patterns among some 18,000 giant cell arteritis patients in France from 2010 to 2022.Use of very high doses declined during this period, but average cumulative doses remained high, and clinically significant adverse effects were seen even at doses of 5 mg/day (prednisone equivalents) or less.
Patients with giant cell arteritis (GCA) in France were kept on glucocorticoids at worrisome levels that led to clinically significant adverse effects, insurance data indicated.
Just looking at patients newly diagnosed in 2022 and followed for 2 years, their cumulative mean dose was 7.6 g in prednisone equivalents -- more than 10 mg/day over the entire interval -- with each gram raising their risk of death by 2.4% (HR 1.024, 95% CI 1.021-1.027), reported Florence Tubach, MD, PhD, of Hôpital Pitié Salpêtrière in Paris, and colleagues.
Rates of major adverse cardiovascular events (MACE) and infections were increased even at relatively low doses, the group noted in RMD Open. Among patients getting an annual average of 5 mg/day or less in prednisone equivalents, infection risk rose by 13% (HR 1.13, 95% CI 1.00-1.29) and risk for MACE increased by 4% (HR 1.04, 95% CI 1.01-1.08), compared with patients with no glucocorticoid exposure.
