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Rheumatology 2005 44(Supplement 3):iii17; doi:10.1093/rheumatology/keh762
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Supplement Article

PP9. LATROGENIC COMPLICATIONS IN GIANT CELL ARTERITIS AND POLYMYALGIA RHEUMATICA: A MULTICENTER, PROSPECTIVE DOUBLE COHORT STUDY

P. Duhaut1, D. Seydoux2, S. Bosshard3, L. Le Page1, D. Boutin4, A. Smail1, R. Cevallos1, H. Pellet5, J. C. Piette4 and J. P. Ducroix1

1 Department of Internal Medicine and RECIF, CHU Nord, Amiens, France, 2 Société de Secours Minière de la Loire, Saint-Etienne, France, 3 Laboratory of Virology and 5 RECIF, Lyon-Grange-Blanche School of Medicine, Lyon, France, 4 Department of Internal Medicine 2, Pitié-Salpêtrière Hospital, Paris, France

Background: Iatrogenic complications of steroids are of particular concern in the elderly. We assessed in a prospective, double cohort study their relative risks in giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) patients compared with population based, age- and sex-matched controls.

Methods: 440 GCA and PMR patients were included at the time of diagnosis, along with 290 randomly selected controls (mean age: 74±8 years). All GCA patients fulfilled the ACR classification criteria. Cases and controls were followed up every six months on a 5-year period with a questionnaire sent to the referent physician and/or the general practitioner, recording adverse effects (including severe infections leading to hospitalization and sigmoid ulcers) and death. Cumulative incidences have been measured over the 12 6-month periods, and Mantel-Haenszel adjusted relative risks with Greenland-Robins 95% interval confidence, computed.

Results: Results are given in table below.


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Conclusion: Although all incidences of steroid-related iatrogenic complications are significantly increased in patients compared to controls, the relative risks usually do not exceed 2. The cumulative incidence rates usually do not exceed 5%, except for weight gain and cushingoid face. The death rates are quite similar in cases and controls. The tolerance of long-term, tapered steroids in the elderly may be better than previously thought for GCA/PMR patients.


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