Recomendaciones de la Sociedad Argentina de Reumatología en el manejo de la arteritis de células gigantes

Versión completa

  • Alejandra Babini Sociedad Argentina de Reumatología, Grupo de confección de preguntas PICO, Panel de expertos
  • Sebastián Magri Sociedad Argentina de Reumatología, Grupo de confección de preguntas PICO, Panel de expertos, Redacción de las recomendaciones
  • Alex Kostianovsky Sociedad Argentina de Reumatología, Grupo de confección de preguntas PICO, Panel de expertos, Revisor
  • Claudia Pena Sociedad Argentina de Reumatología, Panel de expertos, Grupo de confección de preguntas PICO, Revisora
  • Marina Scolnik Sociedad Argentina de Reumatología, Grupo de confección de preguntas PICO, Panel del expertos, Redacción de las recomendaciones
  • Natalia Zamora Sociedad Argentina de Reumatología, Grupo de metodología GRADE
  • María Laura Acosta Felquer Sociedad Argentina de Reumatología, Grupo de metodología GRADE
  • Leandro Carlevaris Sociedad Argentina de Reumatología, Grupo de metodología GRADE
  • Santiago Scarafia Sociedad Argentina de Reumatología, Grupo de metodología GRADE
  • Facundo Vergara Sociedad Argentina de Reumatología, Grupo de metodología GRADE
  • Guillermo Bartel Sociedad Argentina de Reumatología, Panel de expertos
  • Alejandro Brigante Sociedad Argentina de Reumatología, Panel de expertos
  • Oscar Andrés Caicedo Correa Sociedad Argentina de Reumatología, Panel de expertos
  • Ignacio Gandino Sociedad Argentina de Reumatología, Panel de expertos
  • Hugo Laborde Sociedad Argentina de Reumatología, Panel de expertos
  • Nicolás Lloves Schenone Sociedad Argentina de Reumatología, Panel de expertos
  • Alberto Orden Sociedad Argentina de Reumatología, Panel de expertos
  • Nicolás Pérez Sociedad Argentina de Reumatología, Panel de expertos
  • Valeria Scaglioni Sociedad Argentina de Reumatología, Panel de expertos
Palabras clave: arteritis de células gigantes, vasculitis, tratamiento, recomendación

Resumen

La arteritis de células gigantes (ACG) es una vasculitis sistémica que afecta a personas adultas; compromete vasos arteriales de mediano y gran calibre, con potenciales complicaciones de gravedad, como la ceguera, y es considerada una emergencia médica. El objetivo de estas guías fue desarrollar las primeras recomendaciones argentinas para su tratamiento, basadas en la revisión de la literatura mediante metodología GRADE. Un panel de expertos en vasculitis elaboró las preguntas en formato PICO (población, intervención, comparador y outcomes), y luego un panel de expertos en metodología efectuó la revisión de la bibliografía con la extracción de la evidencia para cada una de las preguntas. Se realizó un focus group de pacientes para conocer sus preferencias y experiencias. Finalmente, con la información recabada, el panel de expertos en vasculitis procedió a la votación de las recomendaciones que a continuación se presentan.

Citas

I. Ponte C, Rodrigues AF, O’Neill L, Luqmani RA. Giant cell arteritis: current treatment and management. World J Clin Cases 2015 Jun 16;3(6):484.
II. Buttgereit F, Dejaco C, Matteson EL, Dasgupta B. Polymyalgia rheumatica and giant cell arteritis: a systematic review. JAMA 2016 Jun 14;315(22):2442-58.
III. González-Gay MA, Martínez-Dubois C, Agudo M, Pompei O, Blanco R, Llorca J. Giant cell arteritis: epidemiology, diagnosis, and management. Curr Rheumatol Rep 2010 Dec 21;12(6):436-42.
IV. Sharma A, Mohammad A, Turesson C. Incidence and prevalence of giant cell arteritis and polymyalgia rheumatica: A systematic literature review. Semin Arthritis Rheum 2020 Oct 1;50(5):1040-8.5. Martínez JM, Mollerach FB, Vergara F, Gandino IJ, Scolnik M, Catoggio LJ, et al. Incidence and prevalence of polymyalgia rheumatic and giant cell arteritis: A 15-year study in a health care management organization. Arthritis Rheumatol 2016;68:1521-2.
V. Hellmich B, Agueda A, Monti S, Buttgereit F, De Boysson H, Brouwer E, et al. 2018 Update of the EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis 2020 Jan 1;79(1):19-130.
VI. Maz M, Chung SA, Abril A, Langford CA, Gorelik M, Guyatt G, et al. 2021 American College of Rheumatology/ Vasculitis Foundation Guideline for the management of giant cell arteritis and Takayasu arteritis. Arthritis Rheumatol (Hoboken, NJ) 2021 Aug 1;73(8):1349-65.
VII. Bienvenu B, Ly KH, Lambert M, Agard C, André M, Benhamou Y, et al. Management of giant cell arteritis. Recommendations of the French Study Group for Large Vessel Vasculitis (GEFA). La Rev Med interne 2016 Mar 1;37(3):154-65.
VIII. MacKie SL, Dejaco C, Appenzeller S, Camellino D, Duftner C, González-Chiappe S, et al. British Society for Rheumatology guideline on diagnosis and treatment of giant cell arteritis. Rheumatology (Oxford) 2020 Mar 1;59(3):E1-23.
IX. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev 2016 Dec 5;5(1).
X. Review Manager (RevMan) (Computer program). Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014 (Internet). Citado: 22/04/22. Disponible en: https://training.cochrane.org/onlinelearning/core-software-cochrane-reviews/revman.
XI. GRADEpro GDT: GRADEpro Guideline Development Tool (Software). McMaster University, 2015 (developed by
XII. Evidence Prime, Inc.) (Internet). Disponible en: https:// www.gradepro.org/product.
XIII. Zoom software. Disponible en: https://zoom.us/.
XIV. Chevalet P, Barrier JH, Pottier P, Magadur-Joly G, Pottier MA, Hamidou M, Planchon B, El Kouri D, Connan L, Dupond JL, De Wazieres B, Dien G, Duhamel E, Grosbois B, Jego P, Le Strat A, Capdeville J, Letellier P AL. A randomized, multicenter, controlled trial using intravenous pulses of methylprednisolone in the initial treatment of simple forms of giant cell arteritis: a one year followup study of 164 patients. J Rheumatol 2000;27(6):1484-91.
XV. Kyle V, Hazleman BL. Treatment of polymyalgia rheumatic and giant cell arteritis. I. Steroid regimens in the first two months. Ann Rheum Dis 1989;48(8):658-61.
XVI. Les I, Pijoán JI, Rodríguez-Álvarez R, Ruiz-Irastorza G, Martínez-Berriotxoa A. Effectiveness and safety of medium-dose prednisone in giant cell arteritis: a retrospective cohort study of 103 patients. Clin Exp Rheumatol 2015;33(2 Suppl 89):S-90-7.
XVII. Martínez-Berriotxoa A LI RR. Combined therapy with pulse intravenous methylprednisolone, prednisone and methotrexate in giant cell arteritis [abstract]. Ann Rheum Dis. 2013;72(Supp s3): Session: Poster Tour: Update on therapies for vasc.
XVIII. Mazlumzadeh M, Hunder GG, Easley KA, Calamia KT, Matteson EL, Griffing WL, et al. Treatment of giant cell arteritis using induction therapy with high-dose glucocorticoids: a double-blind, placebo-controlled, randomized prospective clinical trial. Arthritis Rheum 2006 Oct;54(10):3310-8.
XIX. Raine C, Stapleton PP, Merinopoulos D, Maw WW, Achilleos K, Gayford D, et al. A 26-week feasibility study comparing the efficacy and safety of modified-release prednisone with immediate-release prednisolone in newly diagnosed cases of giant cell arteritis. Int J Rheum Dis 2018 Jan 1;21(1):285-91.
XX. González-Gay MA, Blanco R, Rodríguez-Valverde V, Martínez-Taboada VM, Delgado-Rodríguez M, Figueroa M, Uriarte E. Permanent visual loss and cerebrovascular accidents in giant cell arteritis: predictors and response to treatment. Arthritis Rheum 1998;41(8):1497-504.
XXI. Hayreh SS, Zimmerman B, Kardon RH. Visual improvement with corticosteroid therapy in giant cell arteritis. Report of a large study and review of literature. Acta Ophthalmol Scand 2002 Aug;80(4):355-67.
XXII. Buttgereit F, Da Silva JPA, Boers M, Burmester GR, Cutolo M, Jacobs J, et al. Standardised nomenclature for glucocorticoid dosages and glucocorticoid treatment regimens: current questions and tentative answers in rheumatology. Ann Rheum Dis 2002;61(8):718-22.
XXIII. Chan CCK, Paine M, O’Day J. Steroid management in giant cell arteritis. Br J Ophthalmol 2001;85(9):1061-4.
XXIV. Villiger PM, Adler S, Kuchen S, Wermelinger F, Dan D, Fiege V, et al. Tocilizumab for induction and maintenance of remission in giant cell arteritis: a phase 2, randomised, double-blind, placebo-controlled trial. Lancet (London, England) 2016 May 7;387(10031):1921-7.
XXV. Stone JH, Spotswood H, Unizony SH, Aringer M, Blockmans D, Brouwer E, et al. New-onset versus relapsing giant cell arteritis treated with tocilizumab: 3-year results from a randomized controlled trial and extension. Rheumatology (Oxford) 2021 Oct 29.
XXVI. Stone JH, Tuckwell K, Dimonaco S, Klearman M, Aringer M, Blockmans D, et al. Trial of tocilizumab in giant-cell arteritis. N Engl J Med 2017 Jul 27;377(4):317-28.
XXVII. Hoffman GS, Cid MC, Hellmann DB, Guillevin L, Stone JH, Schousboe J, et al. A multicenter, randomized, double-blind, placebo-controlled trial of adjuvant methotrexate treatment for giant cell arteritis. Arthritis Rheum 2002 May;46(5):1309-18.
XXVIII. Spiera RF, Mitnick HJ, Kupersmith M, Richmond M, Spiera H, Peterson MG, et al. A prospective, double-blind, randomized, placebo controlled trial of methotrexate in the treatment of giant cell arteritis (GCA). Clin Exp Rheumatol 2001;19(5):495-501.
XXIX. Jover JA, Hernández-García C, Morado IC, Vargas E, Ba- ñares A, Fernández-Gutiérrez B. Combined treatment of giant-cell arteritis with methotrexate and prednisone. a randomized, double-blind, placebo-controlled trial. Ann Intern Med 2001 Jan 16;134(2):106-14.
XXX. Mahr AD, Jover JA, Spiera RF, Hernández-García C, Fernández-Gutiérrez B, Lavalley MP, et al. Adjunctive methotrexate for treatment of giant cell arteritis: an individual patient data meta-analysis. Arthritis Rheum 2007 Aug;56(8):2789-97.
XXXI. Koster MJ, Yeruva K, Crowson CS, Muratore F, Labarca C, Warrington KJ. Efficacy of methotrexate in real-world management of giant cell arteritis: a case-control study. J Rheumatol 2019;46(5):501-8.
XXXII. Kermani TA, Ytterberg SR, Warrington KJ. Pneumocystis jiroveci pneumonia in giant cell arteritis: A case series. Arthritis Care Res 2011 May;63(5):761-5.
XXXIII. Carbonella A, Berardi G, Petricca L, Biscetti F, Alivernini S, Bosello SL, et al. Immunosuppressive therapy (methotrexate or cyclophosphamide) in combination with corticosteroids in the treatment of giant cell arteritis: comparison with corticosteroids alone. J Am Geriatr Soc 2016 Mar 1;64(3):672-4.
XXXIV. Langford CA, Cuthbertson D, Ytterberg SR, Khalidi N, Monach PA, Carette S, et al. A randomized, double-blind trial of abatacept (CTLA-4Ig) for the treatment of giant cell arteritis. Arthritis Rheumatol (Hoboken, NJ) 2017 Apr 1;69(4):837-45.
XXXV. Matza MA, Fernandes AD, Stone JH, Unizony SH. Ustekinumab for the treatment of giant cell arteritis. Arthritis Care Res (Hoboken) 2021 Jun 1;73(6):893-7.
XXXVI. Karabayas M, Dospinescu P, Fluck N, Kidder D, Fordyce G, Hollick RJ, et al. Evaluation of adjunctive mycophenolate for large vessel giant cell arteritis. Rheumatol Adv Pract 2020;4(2):1-4.
XXXVII. Uddhammar A, Eriksson A-L, Nyström L, Stenling R, Rantapää-Dahlqvist S. Increased mortality due to cardiovascular disease in patients with giant cell arteritis in northern Sweden. J Rheumatol 2002;29(4).
XXXVIII. González-Gay MA, Vázquez-Rodríguez TR, Gómez-Acebo I, Pego-Reigosa R, López-Díaz MJ, Vázquez-Triñanes MC, et al. Strokes at time of disease diagnosis in a series of 287 patients with biopsy-proven giant cell arteritis. Medicine (Baltimore) 2009 Jul;88(4):227-35.
XXXIX. Lee MS, Smith SD, Galor A, Hoffman GS. Antiplatelet and anticoagulant therapy in patients with giant cell arteritis. Arthritis Rheum 2006 Oct;54(10):3306-9.
XL. Nesher G, Berkun Y, Mates M, Baras M, Rubinow A, Sonnenblick M. Low-dose aspirin and prevention of cranial ischemic complications in giant cell arteritis. Arthritis Rheum 2004 Apr;50(4):1332-7.
XLI. González-Gay MA, Piñeiro A, Gómez-Gigirey A, García-Porrua C, Pego-Reigosa R, Dierssen-Sotos T, et al. Influence of traditional risk factors of atherosclerosis in the development of severe ischemic complications in giant cell arteritis. Medicine (Baltimore) 2004 Nov;83(6):342-7.
XLII. Narváez FJG, Bernad B, Gómez-Vaquero C, García-Gó- mez C, Roig-Vilaseca D, Juanola X, et al. Impact of antiplatelet therapy in the development of severe ischemic complications and in the outcome of patients with giant cell arteritis. Clin Exp Rheumatol 2008 May;26(3 Supp. 49).
XLIII. Berger CT, Wolbers M, Meyer P, Daikeler T, Hess C. High incidence of severe ischaemic complications in patients with giant cell arteritis irrespective of platelet count and size, and platelet inhibition. Rheumatology (Oxford) 2009;48(3):258-61.
XLIV. Martínez-Taboada VM, López-Hoyos M, Narváez J, Mu- ñoz-Cacho P. Effect of antiplatelet/anticoagulant therapy on severe ischemic complications in patients with giant cell arteritis: a cumulative meta-analysis. Autoimmun Rev 2014;13(8):788-94.
XLV. Stone JH, Tuckwell K, Dimonaco S, Klearman M, Aringer M, Blockmans D, et al. Trial of tocilizumab in giant-cell arteritis. N Engl J Med 2017 Jul 27;377(4):317-28.
XLVI. Strand V, Dimonaco S, Tuckwell K, Klearman M, Collinson N, Stone JH. Health-related quality of life in patients with giant cell arteritis treated with tocilizumab in a phase 3 randomised controlled trial. Arthritis Res Ther 2019 Feb 20;21(1).
XLVII. Calderón-Goercke M, Loricera J, Aldasoro V, Castañeda S, Villa I, Humbría A, et al. Tocilizumab in giant cell arteritis. Observational, open-label multicenter study of 134 patients in clinical practice. Semin Arthritis Rheum 2019 Aug 1;49(1):126-35.
XLVIII. Calderón-Goercke M, Castañeda S, Aldasoro V, Villa I, Prieto-Peña D, Atienza-Mateo B, et al. Tocilizumab in giant cell arteritis: differences between the GiACTA trial and a multicentre series of patients from the clinical practice. Clin Exp Rheumatol 2020 Mar 1;38 Suppl 124(2):112-9.
XLIX. Evans J, Steel L, Borg F, Dasgupta B. Long-term efficacy and safety of tocilizumab in giant cell arteritis and large vessel vasculitis. RMD open 2016;2(1).
L. Adizie T, Christidis D, Dharmapaliah C, Borg F, Dasgupta B. Efficacy and tolerability of leflunomide in difficult-totreat polymyalgia rheumatica and giant cell arteritis: a case series. Int J Clin Pract 2012 Sep;66(9):906-9.
LI. Tengesdal S, Diamantopoulos AP, Myklebust G. Leflunomide versus methotrexate in treatment of giant cell arteritis: comparison of efficacy, safety, and drug survival. Scand J Rheumatol 2019 Jul 4;48(4):333-5.
LII. De Silva M, Hazleman BL. Azathioprine in giant cell arteritis/polymyalgia rheumatica: a double-blind study. Ann Rheum Dis 1986;45(2):136-8.
LIII. Boureau AS, de Faucal P, Espitia O, De Decker L, Agard C. Place of azathioprine in the treatment of giant cell arteritis. La Rev Med interne 2016 Nov 1;37(11):723-9.
LIV. de Boysson H, Boutemy J, Creveuil C, Ollivier Y, Letellier P, Pagnoux C, et al. Is there a place for cyclophosphamide in the treatment of giant-cell arteritis? A case series and systematic review. Semin Arthritis Rheum 2013 Aug;43(1):105-12.
LV. Henes JC, Müller M, Pfannenberg C, Kanz L, Kötter I. Cyclophosphamide for large-vessel vasculitis: Assessment of response by PET/CT. Clin Exp Rheumatol 2011;29(1 Supp. 64).
LVI. Loock J, Henes J, Kötter I, Witte T, Lamprecht P, Schirmer M, et al. Treatment of refractory giant cell arteritis with cyclophosphamide: A retrospective analysis of 35 patients from three centres. Clin Exp Rheumatol 2012;30(Supp 70).
LVII. de Vita S, Tavoni A, Jeracitano G, Gemignani G, Dolcher MP, Bombardieri S. Treatment of giant cell arteritis with cyclophosphamide pulses. J Intern Med 1992;232(4):373-5.
LVIII. Quartuccio L, Maset M, De maglio G, Pontarini E, Fabris M, Mansutti E, et al. Role of oral cyclophosphamide in the treatment of giant cell arteritis. Rheumatology (Oxford). 2012 Sep;51(9):1677-86.
Publicado
2022-09-01
Cómo citar
1.
Babini A, Magri S, Kostianovsky A, Pena C, Scolnik M, Zamora N, Acosta Felquer ML, Carlevaris L, Scarafia S, Vergara F, Bartel G, Brigante A, Caicedo Correa OA, Gandino I, Laborde H, Lloves Schenone N, Orden A, Pérez N, Scaglioni V. Recomendaciones de la Sociedad Argentina de Reumatología en el manejo de la arteritis de células gigantes: Versión completa. Rev. Argent. Reumatol. [Internet]. 1 de septiembre de 2022 [citado 22 de noviembre de 2024];33(Sup3):1 - 36. Disponible en: https://ojs.reumatologia.org.ar/index.php/revistaSAR/article/view/689