Metabolic features and glucocorticoid-induced comorbidities in patients with giant cell arteritis and polymyalgia rheumatica in a Dutch and Danish cohort

OBJECTIVES: Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are age-associated inflammatory diseases that frequently overlap. Both diseases require long-term treatment with glucocorticoids (GCs), often associated with comorbidities. Previous population-based cohort studies reported that an unhealthier metabolic profile might prevent the development of GCA. Here, we report metabolic features before start of treatment and during treatment in patients with GCA and PMR. METHODS: In the Dutch GCA/PMR/SENEX (GPS) cohort, we analysed metabolic features and prevalence of comorbidities (typ... Mehr ...

Verfasser: Esen, Idil
Arends, Suzanne
Dalsgaard Nielsen, Berit
Therkildsen, Philip
Hansen, Ib
van 't Ende, Anna
Heeringa, Peter
Boots, Annemieke
Hauge, Ellen
Brouwer, Elisabeth
van Sleen, Yannick
Dokumenttyp: Artikel
Erscheinungsdatum: 2023
Reihe/Periodikum: Esen , I , Arends , S , Dalsgaard Nielsen , B , Therkildsen , P , Hansen , I , van 't Ende , A , Heeringa , P , Boots , A , Hauge , E , Brouwer , E & van Sleen , Y 2023 , ' Metabolic features and glucocorticoid-induced comorbidities in patients with giant cell arteritis and polymyalgia rheumatica in a Dutch and Danish cohort ' , BMJ Open , vol. 9 , no. 1 . https://doi.org/10.1136/rmdopen-2022-002640
Schlagwörter: Humans / Giant Cell Arteritis/drug therapy / Polymyalgia Rheumatica/complications / Glucocorticoids/adverse effects / Diabetes Mellitus / Type 2/complications / Obesity/complications / Cataract/epidemiology / Denmark
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29027129
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://hdl.handle.net/11370/07932c01-ca16-45fb-b3cb-a9a6660b7852

OBJECTIVES: Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are age-associated inflammatory diseases that frequently overlap. Both diseases require long-term treatment with glucocorticoids (GCs), often associated with comorbidities. Previous population-based cohort studies reported that an unhealthier metabolic profile might prevent the development of GCA. Here, we report metabolic features before start of treatment and during treatment in patients with GCA and PMR. METHODS: In the Dutch GCA/PMR/SENEX (GPS) cohort, we analysed metabolic features and prevalence of comorbidities (type 2 diabetes, hypercholesterolaemia, hypertension, obesity and cataract) in treatment-naïve patients with GCA (n=50) and PMR (n=42), and compared those with the population-based Lifelines cohort (n=91). To compare our findings in the GPS cohort, we included data from patients with GCA (n=52) and PMR (n=25) from the Aarhus cohort. Laboratory measurements, comorbidities and GC use were recorded for up to 5 years in the GPS cohort. RESULTS: Glycated haemoglobin levels tended to be higher in treatment-naïve patients with GCA, whereas high-density lipoprotein, low-density lipoprotein and cholesterol levels were lower compared with the Lifelines population. Data from the Aarhus cohort were aligned with the findings obtained in the GPS cohort. Presence of comorbidities at baseline did not predict long-term GC requirement. The incidence of diabetes, obesity and cataract among patients with GCA increased upon initiation of GC treatment. CONCLUSION: Data from the GCA and PMR cohorts imply a metabolic dysregulation in treatment-naïve patients with GCA, but not in patients with PMR. Treatment with GCs led to the rise of comorbidities and an unhealthier metabolic profile, stressing the need for prednisone-sparing targeted treatment in these vulnerable patients.