LAUSR

OBJECTIVES We evaluated sensitivity to change and discriminative abilities of vascular ultrasonography (US) scores in disease monitoring in the follow-up of a prospective cohort of new-onset cranial- and large-vessel (LV) GCA patients. METHODS Baseline and follow-up (8 weeks, 24 weeks and 15 months) US of temporal (TA), carotid and axillary arteries included assessment of halo and measurement of the intima media complex (IMC).Max IMC, max halo IMC, sum IMC, sum halo IMC, mean IMC, halo count and the Southend halo score were calculated. The provisional OMERACT ultrasound score, OGUS, was obtained, taking the average of TAs and axillary arteries IMCs divided by their normal cut-off values. RESULTS Baseline US was positive in 44/47 patients (72% TA, 72% LV). Sensitivity to change of all composite US scores containing TAs was evident by week 8 onward. LVs responded poorly and new axillary US lesions emerged in 6 patients despite clinical remission. The OGUS showed a large magnitude of change and is considered the score least prone to potential bias. All TA-based US scores showed moderate-strong correlation with disease activity markers. OGUS, TA halo count, Southend TA halo score, TA sum IMC and TA mean IMC showed potential to discriminate remission and relapse with AUC ≥ 0.8. CONCLUSIONS The OGUS is suggested as an outcome measurement for the assessment of treatment response in clinical trials. The abilities of US scores to discriminate remission and relapse are encouraging and should be further explored.