Steroid therapy improves endothelial function in patients with biopsy-proven giant cell arteritis.

Abstract

OBJECTIVE:

Endothelial dysfunction has been found to be present in subjects with both small and medium-size blood vessel vasculitides. We assess whether endothelial dysfunction was also present in patients with biopsy-proven giant cell arteritis (GCA) and whether it might be improved following steroid treatment.

METHODS:

Endothelial function was determined in cross-sectional and longitudinal studies of 6 patients with biopsy-proven GCA diagnosed between January and May 2002 by measuring flow-mediated endothelial-dependent and independent vasodilatation (EDV and EIV) by brachial ultrasonography. Patients were assessed for endothelial function within 48 hours after the onset of steroid therapy, 4 weeks after the onset of steroid therapy, and 2 years after the disease diagnosis.

RESULTS:

EDV was significantly impaired in patients with GCA compared with 12 matched controls [mean 2.9%, median 2.45% (range 2.1% to 4.7%) vs mean 6.5%, median 6.6% (range 3.9% to 9.3%) in matched controls; p = 0.002]. However, no significant difference existed between patients and controls in EIV. Significant improvement of EDV after the suppression of inflammation was achieved. At Week 4 after the onset of steroid therapy all 6 patients showed enhanced responses (p = 0.028). This improvement of EDV was still present when steroid treatment was ended, 2 years after diagnosis.

CONCLUSION:

Endothelial function is significantly impaired in individuals with active biopsy-proven GCA. The results highlight the importance of steroid therapy to improve endothelial function after suppression of the inflammation of GCA.

• Authors: Carlos Gonzalez-Juanatey, Javier Llorca, Carlos Garcia-Porrua, Amalia Sanchez-Andrade, Javier Martín, Miguel A Gonzalez-Gay
• Journal: The Journal of rheumatology (J Rheumatol) Vol. 33 Issue 1 Pg. 74-8 (Jan 2006) ISSN: 0315-162X [Print] Canada
• PMID: 16395753 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Glucocorticoids
• Methylprednisolone

Topics

• Aged
• Aged, 80 and over
• Biopsy
• Brachial Artery (drug effects, physiology)
• Cross-Sectional Studies
• Dose-Response Relationship, Drug
• Drug Therapy, Combination
• Endothelium, Vascular (drug effects, physiology)
• Female
• Giant Cell Arteritis (drug therapy, pathology, physiopathology)
• Glucocorticoids (therapeutic use)
• Humans
• Longitudinal Studies
• Male
• Methylprednisolone (therapeutic use)
• Regional Blood Flow (drug effects, physiology)
• Vasodilation (drug effects)