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    Objective To evaluate the safety and efficacy of tocilizumab (TCZ) in giant cell arteritis (GCA) in a large North American cohort. Methods Patients with GCA treated with TCZ between January 1, 2010, and May 15, 2020, were retrospectively identified. Kaplan-Meier methods were used to estimate time to TCZ discontinuation and time to first relapse after TCZ discontinuation. Poisson regression models were used to compare annualized relapse rates before, during, and after TCZ use. Age- and sex-adjusted risk factors associated with relapse on and off TCZ and development of adverse events of significant interest (AESIs) were examined using Cox models. Results One hundred fourteen patients (60.5% female) were included with mean (SD) age 70.4 (8.2) years. Median duration from GCA diagnosis to TCZ start was 4.5 months. Median overall duration of TCZ treatment was 2.3 years. Relapse rate prior to TCZ start (0.84 relapses/person-year) was 3-fold reduced while on TCZ (0.28 relapses/person-year; P <

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    Bywaters lesion is a cutaneous vasculitis seen in rheumatoid arthritis.1 A 70-year-old man presenting with polyarthritis and finger papules visited our hospital. The patient had a 12-year history of polyarthritis, and bilateral ulnar deviation developed 5 years prior. Computed tomography indicated interstitial pneumonia, and blood work confirmed a rheumatoid factor level of 2708 (normal < 15) IU/mL and anticyclic citrullinated peptide antibody …

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    Objective To investigate the occurrence of cardiovascular events (CVEs) in a large cohort of patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) across the European Union, China, Turkey, Russia, the United Kingdom, and the USA. Methods Patients with a definite diagnosis of AAV who were followed for ≥ 3 months and had sufficient documentation were included. Data on myocardial infarction (MI) and stroke were collected retrospectively from tertiary vasculitis centers. Univariate and multivariate Cox regression models were used to estimate hazard ratios (HRs) and 95% CIs. Results Over a median follow-up of 62.0 months (IQR 22.6-100.0), CVEs (mostly MIs) occurred in 245 (10.7%) of 2286 patients with AAV, with a higher frequency in China and the UK. On multivariate regression analysis, older age (55-64.9 yrs, HR 2.93, 95% CI 1.99-4.31), smoking (HR 1.98, 95% CI 1.48-2.64), Chinese origin (HR 4.24, 95% CI 3.07-5.85), and pulmonary (HR 1.50, 95% CI 1.09-2.06) a

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    Premature atherosclerosis has been observed during the course of different systemic inflammatory diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus, and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).1-3 As a result, cardiovascular (CV) events, including myocardial infarction, stroke, heart failure, coronary artery disease, and death, occur 1.65 to 3 times more commonly in patients with AAV as compared to the general population, and the risk appears to be highest in the first year following diagnosis.3 After the first year, however, CV disease (CVD) remains the most important cause of death besides malignancy and infection. It has been demonstrated that traditional risk factors for CVD, such as hypertension, dyslipidemia, diabetes, age, and a family history of CVD, are highly prevalent in AAV. In this issue of The Journal of Rheumatology , Moiseev et al demonstrated that smoking and pulmonary involvement were also associated with an increa

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