{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T12:14:26Z","timestamp":1783426466613,"version":"3.54.6"},"reference-count":30,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"unspecified","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2026,6,9]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Recent advances in giant cell arteritis (GCA) management aim to reduce glucocorticoid (GC). We described changes in treatment patterns over time in real life and assessed associations between cumulative GC use and adverse outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective population-based study used the French national health insurance database (Syst\u00e8me National des Donn\u00e9es de Sant\u00e9) and included 18\u2009301 incident GCA cases between 2010 and 2022. Latent class growth modelling identified GC use trajectories. We described trends in cumulative dose and sparing agent use. Multivariable survival models assessed factors associated with sustained GC-free remission and association between GC cumulative exposure and mortality, serious infections, major adverse cardiovascular events (MACE) and osteoporotic fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four GC use trajectories were identified. Two high-dose trajectories declined over time. Yet, mean 2-year cumulative GC dose remained high, reaching 7.6 g among patients diagnosed in 2022. Methotrexate use increased until 2020 and plateaued thereafter while tocilizumab prescriptions rose, reaching over 25% in 2022. Male sex and baseline methotrexate or tocilizumab use were associated with faster GC tapering, while age &gt;75 years, hypertension, kidney and neurodegenerative diseases were associated with slower tapering. Each gram of GC was associated with higher mortality (HR per gram 1.024, 95% CI 1.021 to 1.027). Yearly cumulative exposure to doses \u22645\u2009mg\/day was associated with increased infection (HR 1.13, 95% CI 1.00 to 1.29)\u2009and MACE (HR 1.04, 95% CI 1.01 to 1.08).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite reductions in high-dose use, cumulative GC exposure in GCA remains substantial and associated with adverse outcomes, even at the lowest doses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2026-006866","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T11:21:29Z","timestamp":1783423289000},"page":"e006866","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Glucocorticoid in giant cell arteritis: real-world treatment patterns over time and associated burden in a nationwide hospital-based study within the French health insurance database"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4924-093X","authenticated-orcid":false,"given":"Maxime","family":"Beydon","sequence":"first","affiliation":[{"name":"Sorbonne Universit\u00e9, INSERM, Institut Sorbonne de Sant\u00e9 Publique, Equipe PEPITES, AP-HP, H\u00f4pital Piti\u00e9 Salp\u00eatri\u00e8re, D\u00e9partement de Sant\u00e9 Publique, Centre de Pharmaco\u00e9pid\u00e9miologie (Cephepi), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Lacaille","sequence":"additional","affiliation":[{"name":"Arthritis Research Canada, Vancouver, British Columbia, Canada"},{"name":"Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8845-4274","authenticated-orcid":false,"given":"Bruno","family":"Fautrel","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, INSERM, Institut Sorbonne de Sant\u00e9 Publique, Equipe PEPITES, AP-HP, H\u00f4pital Piti\u00e9 Salp\u00eatri\u00e8re, D\u00e9partement de Sant\u00e9 Publique, Centre de Pharmaco\u00e9pid\u00e9miologie (Cephepi), Paris, France"},{"name":"Sorbonne Universit\u00e9 - APHP, CRI-IMIDIATE Clinical Research Network, Department of Rheumatology, H\u00f4pital Piti\u00e9 Salp\u00eatri\u00e8re, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5523-1856","authenticated-orcid":false,"given":"Rapha\u00e8le","family":"Seror","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, H\u00f4pital Bic\u00eatre, Assistance Publique - H\u00f4pitaux de Paris, Universit\u00e9 Paris-Saclay, Orsay, France"},{"name":"Centre de Recherche en Epid\u00e9miologie et Sant\u00e9 des Populations, Universit\u00e9 Paris-Saclay, Orsay, France"},{"name":"Inserm, Institut Gustave Roussy, Universit\u00e9 Versailles Saint Quentin, Versailles, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hajage","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, INSERM, Institut Sorbonne de Sant\u00e9 Publique, Equipe PEPITES, AP-HP, H\u00f4pital Piti\u00e9 Salp\u00eatri\u00e8re, D\u00e9partement de Sant\u00e9 Publique, Centre de Pharmaco\u00e9pid\u00e9miologie (Cephepi), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Tubach","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, INSERM, Institut Sorbonne de Sant\u00e9 Publique, Equipe PEPITES, AP-HP, H\u00f4pital Piti\u00e9 Salp\u00eatri\u00e8re, D\u00e9partement de Sant\u00e9 Publique, Centre de 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