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首页> 外文期刊>Seminars in Arthritis and Rheumatism >Treatment with angiotensin II receptor blockers is associated with prolonged relapse-free survival, lower relapse rate, and corticosteroid-sparing effect in patients with giant cell arteritis
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Treatment with angiotensin II receptor blockers is associated with prolonged relapse-free survival, lower relapse rate, and corticosteroid-sparing effect in patients with giant cell arteritis

机译：血管紧张素II受体阻滞剂的治疗与巨细胞性动脉炎患者的无复发生存期延长，复发率降低和皮质类固醇激素节省作用有关

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Objective: To determine whether concomitant treatment with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) is associated with changes in the outcome of patients with giant cell arteritis (GCA). Methods: A study cohort of 106 patients with biopsy-proven GCA was longitudinally followed up for 7.8 ± 3.3 years. Patients were stratified according to their treatment with ACEI, ARB, or no ACEI/ARB. Time to first relapse, number of flares, time to achieve a stable prednisone dose <10. mg/day and <5. mg/day with no relapses, time required to completely discontinue prednisone, cumulative dose of prednisone received during the first year, and concentrations of acute-phase reactants at pre-defined time points (baseline, 6, 12, 18, and 24 months) were compared among the 3 groups. Cox proportional hazards models were performed to adjust for potential confounders. Results: Patients receiving ARB presented a significantly longer relapse-free survival than patients treated with ACEI or patients not receiving ACEI/ARB (p = 0.02). The adjusted hazard ratio for relapses in patients treated with ARB was 0.32 (95% CI: 0.12-0.81, p = 0.017). In addition, patients who received ARB achieved a prednisone maintenance dose <10. mg/day faster than all other patients (p = 0.0002). No significant differences were observed among groups in acute-phase reactant levels during follow-up. However, patients not receiving ACEI/ARB had significantly higher C-reactive protein and haptoglobin concentrations than those receiving ACEI or ARB at various time points. Conclusions: Addition of ARB to glucocorticoids is associated with lower relapse rate and more prolonged disease-free survival in patients with GCA.
机译：目的：确定伴随血管紧张素转换酶抑制剂（ACEI）或血管紧张素受体阻滞剂（ARB）的治疗是否与巨细胞性动脉炎（GCA）患者预后的改变相关。方法：对106例经活检证实的GCA患者进行纵向研究，随访时间为7.8±3。3年。根据使用ACEI，ARB或不使用ACEI / ARB的治疗对患者进行分层。首次复发的时间，耀斑数量，达到稳定的泼尼松剂量<10的时间。毫克/天且<5。毫克/天（无复发），完全停用泼尼松所需的时间，第一年接受的泼尼松累积剂量以及在预定时间点（基线，6、12、18和24个月）的急性期反应物浓度在3组之间进行比较。进行Cox比例风险模型以调整潜在的混杂因素。结果：与接受ACEI治疗的患者或未接受ACEI / ARB的患者相比，接受ARB的患者表现出更长的无复发生存期（p = 0.02）。接受ARB治疗的患者经调整的复发风险比为0.32（95％CI：0.12-0.81，p = 0.017）。此外，接受ARB的患者的泼尼松维持剂量<10。毫克/天比所有其他患者快（p = 0.0002）。在随访期间，各组之间的急性期反应物水平没有观察到显着差异。然而，在不同时间点未接受ACEI / ARB的患者的C反应蛋白和触珠蛋白浓度明显高于接受ACEI或ARB的患者。结论：糖皮质激素中添加ARB与GCA患者的复发率降低和无病生存期延长有关。

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