Abstract
Little is known about the impact of giant cell arteritis (GCA) and its treatment on patient-reported physical, mental, and psychic quality of life (QoL). In this monocentric study, a questionnaire was sent to the 100 last patients diagnosed with GCA and followed-up in a single tertiary center. Their physical, mental and psychic status were self-assessed via close-ended questions, the 12-item short form survey (SF-12) and the 15-item geriatric depression scale (GDS). We aimed to identify parameters that were significantly associated with moderate-to-severe disability in both physical and mental domains. Ninety patients were analyzable. Moderate to severe physical disability was found in 41 (46%) patients. In multivariate analysis, walking difficulties (OR, 95% CI 8.42 [2.98–26.82], p <0.0001), muscle mass and strength reduction (OR, 95% CI 4.38 [1.37–16.31], p = 0.01) and age >80 (OR, 95% CI 4.21 [1.44–13.61], p = 0.008) were independent findings associated with moderate to severe physical disability. Moderate to severe mental disability was found in 30 (33%) patients. In multivariate analysis, depressive mood (OR, 95% CI 11.05 [3.78–37.11], p < 0.0001), felt adverse events attributable to glucocorticoids (OR, 95% CI 10.54 [1.65–213.1], p = 0.01) and use of immune-suppressants (OR, 95% CI 3.50 [1.14–11.87], p = 0.03) were independent findings associated with moderate to severe mental disability. There was a statistically significant negative correlation between GDS and the physical and/or mental disability scores (GDS and PCS-12: r = −0.33, p = 0.0013; GDS and MCS-12: r = −0.36, p = 0.0005). In conclusion, this study identified via a self-assessment of patients with GCA some medical and modifiable findings that significantly affect their physical and mental quality of life. A better knowledge of these factors may help improve the care of GCA patients.
Highlights
Giant cell arteritis (GCA) is the most frequent systemic vasculitis, typically affecting patients over 50
We showed that approximately one-third to half of patients reported a physical and/or mental disability attributable to GCA and its treatment in the months or years following diagnosis
We observed that the described physical disabilities were not directly associated with GCA manifestations or with treatment management
Summary
Giant cell arteritis (GCA) is the most frequent systemic vasculitis, typically affecting patients over 50. The mean age of GCA diagnosis in different studies ranges between 70 and 80 years old [1]. The disease burden includes a chronic course and a subsequent prolonged treatment [2, 3], especially because of a high risk of relapse that affects approximately half of patients [4]. The disease and its symptoms, the chronic course and the treatment probably have an impact on the patients’ quality of life (QoL), but few studies have been dedicated to this description. Medical consultations during the follow-up of a GCA patient are relatively time-limited and mostly focus on the evaluation of disease activity and treatment tolerance, both being mainly analyzed from a medical point of view
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