TOPLINE

In a multinational survey, although most rheumatologists aimed to stop glucocorticoids by 24 months, three quarters of patients remained on treatment at 4 years. Adverse events were common, and use of steroid-sparing advanced therapies remained low despite strong support for earlier use.

METHODOLOGY

• Rheumatologists in the European Union-5 countries (France, Germany, Italy, Spain, United Kingdom) and the United States completed a cross-sectional retrospective survey between May and October 2024.
• Overall, 196 rheumatologists reported on 846 patients (mean age, 71 years; 63% women; median time since GCA diagnosis, 14.2 months). Of them, 221 (26.1%) self-reported their treatment experiences and preferences.
• The study assessed rheumatologists’ perceptions of advanced therapies, prescribing patterns, and glucocorticoid use using patient record forms and line-based dose calculations over a 12-month observation period.
• For patients diagnosed with GCA less than 12, 12-24, and more than 24 months ago, median cumulative glucocorticoid doses over the last 12 months were 4343, 5200, and 2196 mg, respectively; at least 99% received glucocorticoids within the last 12 months.

TAKEAWAY

• Although most rheumatologists intended to stop glucocorticoids by 24 months, 80% of patients were still receiving them at 24 to <36 months and 75% at ≥48 months at an average of 8.4 mg/day and 5.3 mg/day, respectively.
• Most rheumatologists (at least 90%) agreed that advanced therapies should be given early in GCA treatment, and many also cited limited administration routes as a barrier and said more treatment options would increase use.
• Rheumatologists rated remission maintenance, glucocorticoid-free remission, steroid reduction, glucocorticoid cessation, safety, and patient adherence as highly important for advanced therapy. Most also valued convenient administration, and 75% of patients preferred oral treatment over injection or infusion.
• Both patients and rheumatologists reported glucocorticoid-related adverse events, most commonly weight gain, fatigue, and fluid retention.

IN PRACTICE

"Optimizing treatment strategies beyond GCs is critical, and greater real-world adoption of advanced therapies could close the gap between guideline recommendations and clinical practice," the authors of the study concluded.

SOURCE

The study was led by Anisha B. Dua, MD, Northwestern University Feinberg School of Medicine in Chicago. It was published online on August 28 in Rheumatology and Therapy.

LIMITATIONS

The retrospective design limited causal inference. The survey captured limited clinical detail and was industry sponsored. The sample may not have been fully representative of all patients with GCA, particularly those outside the EU-5 countries and the United States.

DISCLOSURES

The study was funded by AbbVie. Four authors declared serving as employees of and held stock or stock options with AbbVie. Dua received consulting fees from AbbVie, Amgen, AstraZeneca, GlaxoSmithKline, Novartis, and Sanofi; participated in clinical trials or received grant support from Amgen, Novartis, and Rheumatology Research Foundation; and served on the Board of Directors for Vasculitis Foundation and Rheumatology Research Foundation. Full disclosures are reported in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.