TY - JOUR
T1 - Ultrasound halo sign as a potential monitoring tool for patients with giant cell arteritis
T2 - A prospective analysis
AU - Ponte, Cristina
AU - Monti, Sara
AU - Scirè, Carlo Alberto
AU - Delvino, Paolo
AU - Khmelinskii, Nikita
AU - Milanesi, Alessandra
AU - Teixeira, Vítor
AU - Brandolino, Fabio
AU - Saraiva, Fernando
AU - Montecucco, Carlomaurizio
AU - Fonseca, João Eurico
AU - Schmidt, Wolfgang A.
AU - Luqmani, Raashid Ahmed
N1 - Funding Information:
Funding CP’s work was supported in part by a grant from the Portuguese Society of Rheumatology.
Publisher Copyright:
© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Objectives To assess the sensitivity to change of ultrasound halo features and their association with disease activity and glucocorticoid (GC) treatment in patients with newly diagnosed giant cell arteritis (GCA). Methods Prospective study of patients with ultrasound-confirmed GCA who underwent serial ultrasound assessments of the temporal artery (TA) and axillary artery (AX) at fixed time points. The number of segments with halo and maximum halo intima-media thickness (IMT) was recorded. Time points in which >80% of patients were assessed were considered for analysis. Halo features at disease presentation and first relapse were compared. Results 49 patients were assessed at 354 visits. Halo sensitivity to change was assessed at weeks 1, 3, 6, 12 and 24 and showed a significant standardised mean difference between all time points and baseline for the TA halo features but only after week 6 for the AX halo features. The number of TA segments with halo and sum and maximum TA halo IMT showed a significant correlation with erythrocyte sedimentation rate (0.41, 0.44 and 0.48), C reactive protein (0.34, 0.39 and 0.41), Birmingham Vasculitis Activity Score (0.29, 0.36 and 0.35) and GC cumulative dose (-0.34,-0.37 and-0.32); no significant correlation was found for the AX halo features. Halo sign was present in 94% of first disease relapses but with a lower mean number of segments with halo and sum of halo IMT compared with disease onset (2.93±1.59 mm vs 4.85±1.51 mm, p=0.0012; 2.01±1.13 mm vs 4.49±1.95 mm, p=0.0012). Conclusions Ultrasound is a useful imaging tool to assess disease activity and response to treatment in patients with GCA.
AB - Objectives To assess the sensitivity to change of ultrasound halo features and their association with disease activity and glucocorticoid (GC) treatment in patients with newly diagnosed giant cell arteritis (GCA). Methods Prospective study of patients with ultrasound-confirmed GCA who underwent serial ultrasound assessments of the temporal artery (TA) and axillary artery (AX) at fixed time points. The number of segments with halo and maximum halo intima-media thickness (IMT) was recorded. Time points in which >80% of patients were assessed were considered for analysis. Halo features at disease presentation and first relapse were compared. Results 49 patients were assessed at 354 visits. Halo sensitivity to change was assessed at weeks 1, 3, 6, 12 and 24 and showed a significant standardised mean difference between all time points and baseline for the TA halo features but only after week 6 for the AX halo features. The number of TA segments with halo and sum and maximum TA halo IMT showed a significant correlation with erythrocyte sedimentation rate (0.41, 0.44 and 0.48), C reactive protein (0.34, 0.39 and 0.41), Birmingham Vasculitis Activity Score (0.29, 0.36 and 0.35) and GC cumulative dose (-0.34,-0.37 and-0.32); no significant correlation was found for the AX halo features. Halo sign was present in 94% of first disease relapses but with a lower mean number of segments with halo and sum of halo IMT compared with disease onset (2.93±1.59 mm vs 4.85±1.51 mm, p=0.0012; 2.01±1.13 mm vs 4.49±1.95 mm, p=0.0012). Conclusions Ultrasound is a useful imaging tool to assess disease activity and response to treatment in patients with GCA.
KW - Giant cell arteritis
KW - Systemic vasculitis
KW - Ultrasonography
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U2 - 10.1136/annrheumdis-2021-220306
DO - 10.1136/annrheumdis-2021-220306
M3 - Article
C2 - 34215646
AN - SCOPUS:85117080853
VL - 80
SP - 1475
EP - 1482
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
SN - 0003-4967
IS - 11
ER -