Prognosis of Giant Cell Arteritis Including Temporal Arteritis and Polymyalgia Rheumatica

Abstract
Patients (90) with giant cell arteritis (GCA) were followed 3-10 yr after the diagnosis. The mean observation time was 63 mo. Thirteen patients died. Corticosteroids were administered to all but 1 patient; 35 were still on treatment after a mean observation period of 59 mo. In 38 patients, 94 flare-ups of the disease were recorded during corticosteroid treatment, most occurring during the 1st yr of treatment and when a low dose of prednisolone was given. Relapses (33), 76% within 3 mo., occurred in 28 patients after withdrawal of treatment. One patient relapsed after > 10 yr of disease. Polymyalgia rheumatica was the most common symptom of flare-up or relapse, regardless of the clinical picture at the time of diagnosis. The duration of treatment should be individualized. One yr of treatment is enough in a few patients, but others need steroid therapy for > 4 yr. The rate of intercurrent disease and complications of GCA or its treatment was low. No patient developed severe eye damage due to GCA. The mortality rate was lower than expected with regard to age and sex.