Poster Session A
Vasculitis
Elvis Hysa, MD
University of Genoa
Genoa, Genoa, Italy
No financial relationships with ineligible companies to disclose
Grade-2 LVV was present in 32 (39%) out of 83 patients with PMR and grade-3 LVV in 10 (12%). The average prednisone daily dosage prescribed at V0 was 15.4 ± 6.3 mg and 19 patients (23%) were already prednisone-treated. At follow-up, 35% of PMR patients experienced at least one PMR flare and 10% showed at least one relapse in the form of GCA. The highest remission rate (92%) was achieved at the 24th month (Fig 1).
The baseline TJS was inversely associated with PMR relapses (β = -0.22, p = 0.04). In GC-naïve PMR patients, increased TJS values were directly associated with a higher likelihood of achieving remission at 6th month (OR = 1.11, 95%CI [1.01-1.23], p = 0.02). None of these associations were influenced by the initial treatment with GC or MTX at mediation analysis (all p > 0.05). However, the cut-off value of TJS = 19 displayed a sensitivity of only 50% and a specificity of 30% in predicting remission, considering the events over the three years of observation (areas under the ROC curves < 0.8, Fig 2).
Baseline TVS was directly but marginally associated with MTX prescription at follow-up (β = 0.08, p = 0.01) but the presence of grade-2 or 3 LVV at baseline was not significantly associated to poor prognostic outcomes at univariate analyses (all p-values > 0.05).
Conclusion:
High FDG-PET/CT-detected musculoskeletal inflammation may be a positive prognostic factor in PMR and might potentially identify phenotypes of PMR patients better responding to GC treatment. Conversely, higher TVS values might predict the need for immunosuppressive treatment.
References: [1] Leeb B et al. Ann Rheum Dis 2004, [2] Dejaco C et al. Ann Rheum Dis 2011
Fig 1. Outcomes in PMR patients with or without grade-3 LVV at different time points.
Fig 2. ROC curve related to the sensitivity and specificity of TJS in predicting the event “remission” in the whole cohort of PMR patients (n = 83) on the left and in the subset of GC-naïve patients (on the right).
E. Hysa: None; D. Camellino: None; C. Bernini: None; P. Clini: None; M. Bauckneht: None; s. Morbelli: None; G. Sambuceti: None; E. Gotelli: None; A. Sulli: AbbVie/Abbott, 5, Baldacci, 2, 5, UCB, 5; M. Cutolo: AbbVie/Abbott, 5, Amgen, 5, Balcacci, 2, 5, Boehringer-Ingelheim, 2, 5, Bristol-Myers Squibb(BMS), 2, 5, UCB, 5; M. Cimmino: None.