CLINICAL COURSE OF GIANT-CELL ARTERITIS - A SERIES OF 42 CURED PATIENTS

We report a prospective study of 42 patients with biopsy-proven giant cell arteritis (CGA) who recovered for more than one year (mean follow up of 71 months since withdrawal of steroid treatment). It was used t he same regimen of prednisone and well closely monitored along the who le treatment. In 22 patients, dapsone was given concomitantly with pre dnisone. Mean duration of steroid therapy was 23.1 months (range: 6-57 months); it was significantly decreased with treatment by dapsone (12 months and 12 days). Age, sex, initial clinical and biological (acute phase reactants) findings did not provide useful information for pred icting steroid treatment needed for recovery. Thirty-six relapses were observed in 22 patients (60 %) during treatment or after its withdraw al. Incidence of relapses declined during steroid treatment and relaps es were (only) observed over first 6 months after steroid withdrawal. Three amaurosis fugax occurred at the beginning of treatment and an ax illar bilateral stenosis was also observed. Forty-eight side effects o f corticosteroids were recorded in 26 patients (63 %) : myopathy (n = 12), bone complications (n = 11), metabolic complications (n = 9). Twe lve patients (63 %) had experienced side effects of dapsone. This stud y emphasized the difficulty in treating CGA. Close monitoring is requi red. A steroid regimen is recommended.