Objectives To determine clinical characteristics, outcome and occurrence of comorbidities in patients with biopsy-confirmed giant cell arteritis (GCA) treated with intravenous methylprednisolone (IVMP) vs those receiving oral glucocorticoids (OGC) only. Methods A retrospective study included patients with GCA diagnosed from 2004 through 2019. Clinical and laboratory characteristics, and cumulative GC dose were compared in patients receiving IVMP vs OGCs. Changes in visual acuity (VA), occurrence of comorbidities after GCA diagnosis, and mortality were analysed. Results A total of 419 patients (69% female) were included. In total, 111 patients were initially treated with IVMP, 104 (94%) of whom showed visual manifestations at onset and 308 received OGCs only. Ninety patients (21.5%) exhibited visual involvement at onset, verified by an ophthalmologist. Compared with OGC, patients receiving IVMP exhibited lower inflammatory response at presentation. There was a tendency for improvement in VA with the use of IVMP, but the results were not statistically significant (OR 1.19, 95% CI 0.35–4.01). Patients treated with IVMP had a higher risk of newly diagnosed diabetes mellitus within a year of GCA diagnosis (OR 2.59, 95% CI 1.19–5.63). This risk remained elevated after adjusting for cumulative OGC dose at three months (adjusted OR 3.30, 95% CI 1.29–8.43). There was no difference in survival between treatment groups. Conclusions Our study found no evidence supporting any benefit of using IVMP in improving VA or survival. IVMP may increase diabetes risk within a year of GCA diagnosis. Further studies are needed to evaluate the value of IVMP in GCA.

中文翻译：

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静脉注射甲泼尼龙治疗巨细胞动脉炎：一项基于人群的研究


目的 确定经活检证实的巨细胞动脉炎 （GCA） 接受静脉注射甲泼尼龙 （IVMP） 与仅接受口服糖皮质激素 （OGC） 的患者的临床特征、结局和合并症的发生。方法 一项回顾性研究纳入了 2004 年至 2019 年诊断的 GCA 患者。比较接受 IVMP 与 OGCs 的患者的临床和实验室特征以及累积 GC 剂量。分析了视力 （VA） 的变化、GCA 诊断后合并症的发生率和死亡率。结果 共纳入 419 例患者 （69% 为女性）。共有 111 例患者最初接受了 IVMP 治疗，其中 104 例 （94%） 在发病时表现出视觉表现，308 例仅接受 OGC。90 例患者 （21.5%） 在发病时表现出视觉受累，经眼科医生证实。与 OGC 相比，接受 IVMP 的患者在就诊时表现出较低的炎症反应。使用 IVMP 有改善 VA 的趋势，但结果无统计学意义 （OR 1.19,95% CI 0.35–4.01）。接受 IVMP 治疗的患者在 GCA 诊断后一年内新诊断糖尿病的风险更高 （OR 2.59,95% CI 1.19-5.63）。在调整 3 个月时的累积 OGC 剂量后，这种风险仍然升高 （调整后的 OR 3.30,95% CI 1.29-8.43）。治疗组之间的生存率没有差异。结论 我们的研究发现没有证据支持使用 IVMP 在改善 VA 或生存率方面有任何益处。IVMP 可能会在 GCA 诊断后一年内增加糖尿病风险。需要进一步的研究来评估 IVMP 在 GCA 中的价值。