Prognostic value of quantifying vascular inflammation through ultrasound in patients with giant cell arteritis: the MAGiCUS study

OBJECTIVES: To assess the prognostic value of ultrasound-based quantification of vascular inflammation for predicting relapses in giant cell arteritis (GCA). METHODS: The Monitoring Activity of GCA through UltraSound (MAGiCUS) project is an international, multicentre, prospective, observational study including newly diagnosed GCA patients. Ultrasound of temporal and axillary arteries was conducted at baseline, 1, 3, 6, and 12 months. Vascular inflammation was quantified using the OMERACT GCA Ultrasonographic Score (OGUS). The primary outcome was the occurrence of the first clinical relapse between 6 and 12 months. RESULTS: Among 156 GCA patients from 19 centres, 31 (19.9%) experienced a relapse. In patients without a relapse, OGUS was significantly lower at all follow-up visits than baseline (-0.15 to -0.35). Baseline OGUS was significantly higher in relapsing patients (1.58 vs 1.16, p < 0.001). In multivariate analysis, an increase in 0.1 units in baseline OGUS was associated with relapse (OR 1.19, 95% CI 1.08, 1.34). This association remained significant for 0.1 increases in OGUS at 1 month (OR 1.37, 95% CI 1.17, 1.66) and at 3 months (OR 1.51, 95% CI 1.20, 1.98). The areas under the receiver operating characteristic curve for predicting relapse were 0.70 (95% CI 0.58 -0.80) for baseline OGUS, 0.74 (95% CI 0.60 -0.85) at 1 month, and 0.67 (95% CI 0.56 -0.78) at 3 months. CONCLUSION: Ultrasound-based quantification of vascular inflammation has prognostic value for predicting relapses during follow-up in GCA. Higher baseline, 1-month and 3-months OGUS are associated with an increased probability of clinical relapse.

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Lara D. Veeken
Published
2026-06-30
DOI
https://doi.org/10.1093/rheumatology/keag341
Primary Topic
Vasculitis and related conditions
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article
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article

Prognostic value of quantifying vascular inflammation through ultrasound in patients with giant cell arteritis: the MAGiCUS study

Cristina Ponte, Colm Kirby, José María Álvaro‐Gracia, J. Molina Collada et al.
Lara D. Veeken
Vasculitis and related conditions
article

Prognostic value of quantifying vascular inflammation through ultrasound in patients with giant cell arteritis: the MAGiCUS study

Cristina Ponte, Colm Kirby, José María Álvaro‐Gracia, J. Molina Collada, O. Camacho, Richard Conway, I. Monjo, P Santamaria, Carlo Salvarani, Alessandra Milanesi, E. Calvo, Milena Bond, Eugenio de Miguel, Perceval Vellosillo, Boris Blanco, Sharon Cowley, Vanessa Quick, Juan José de Agustín, Pablo González Navarro, Isabel Castrejón, Carmen Moragues, Edoardo Conticini, Pierluigi Macchioni, Patricia Harkins, Diana Prieto Peña, Sara M. Monti, Antonio Mera, Yasser El Miedany, Christian Dejaco, Rositsa Karalilova, Paula Estrada Alarcón, David Kane, Francesco Placido, R Padoan, Luca Iorio, Julio Sánchez, MAGiCUS Project Collaborative Group
article en

Abstract

OBJECTIVES: To assess the prognostic value of ultrasound-based quantification of vascular inflammation for predicting relapses in giant cell arteritis (GCA). METHODS: The Monitoring Activity of GCA through UltraSound (MAGiCUS) project is an international, multicentre, prospective, observational study including newly diagnosed GCA patients. Ultrasound of temporal and axillary arteries was conducted at baseline, 1, 3, 6, and 12 months. Vascular inflammation was quantified using the OMERACT GCA Ultrasonographic Score (OGUS). The primary outcome was the occurrence of the first clinical relapse between 6 and 12 months. RESULTS: Among 156 GCA patients from 19 centres, 31 (19.9%) experienced a relapse. In patients without a relapse, OGUS was significantly lower at all follow-up visits than baseline (-0.15 to -0.35). Baseline OGUS was significantly higher in relapsing patients (1.58 vs 1.16, p < 0.001). In multivariate analysis, an increase in 0.1 units in baseline OGUS was associated with relapse (OR 1.19, 95% CI 1.08, 1.34). This association remained significant for 0.1 increases in OGUS at 1 month (OR 1.37, 95% CI 1.17, 1.66) and at 3 months (OR 1.51, 95% CI 1.20, 1.98). The areas under the receiver operating characteristic curve for predicting relapse were 0.70 (95% CI 0.58 -0.80) for baseline OGUS, 0.74 (95% CI 0.60 -0.85) at 1 month, and 0.67 (95% CI 0.56 -0.78) at 3 months. CONCLUSION: Ultrasound-based quantification of vascular inflammation has prognostic value for predicting relapses during follow-up in GCA. Higher baseline, 1-month and 3-months OGUS are associated with an increased probability of clinical relapse.

Lara D. Veeken
University of Siena (IT), Ain Shams University (EG), Universidad Complutense de Madrid (ES), University of Modena and Reggio Emilia (IT), University of Padua (IT), University of Bedfordshire (GB), University of Milan (IT), Medical University of Graz (AT), Paracelsus Medical University (AT), Hospital Universitario La Paz (ES), Medical University Plovdiv (BG), Raja Isteri Pengiran Anak Saleha Hospital (BN), Bellvitge University Hospital (ES), Tallaght University Hospital (IE), Hospital General Universitario Gregorio Marañón (ES), Azienda Sanitaria Unità Locale di Reggio Emilia (IT), Ain Shams University Hospital (EG), Complejo Hospitalario Universitario de Santiago (ES), Krankenhaus Bruneck (IT), Centro Nacional de Biotecnología (ES), Administração Regional de Saúde de Lisboa e Vale do Tejo (PT), Instituto de Investigación Marqués de Valdecilla (ES), Institute for Rheumatic Diseases (Japan) (JP), Vall d'Hebron Hospital Universitari (ES), Hospital de Sant Joan Despí Moisès Broggi (ES), Bedford Hospital NHS Trust (GB), IRCCS Istituto Auxologico Italiano (IT), Rheumatology Consultants (US), Hospital de Santa Maria (PT), Policlinico San Matteo Fondazione (IT), St. James's Hospital (IE), Center for Rheumatology (US), Hospital Universitario Ramón y Cajal (ES), Hospital Universitario Infanta Leonor (ES), Universitat de Barcelona (ES), Universidad Politécnica de Madrid (ES)
Good health and well-being
Openalex Percentile: Top 7%
Vasculitis and related conditions
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