Treatment and Evolution of 134 Patients With Aortitis and Periaortitis. Experience of a Third Level University Hospital

Objective Aortitis and periaortitis include a heterogeneous group of conditions, which may be idiopathic or secondary to infectious diseases or non-infectious inflammatory disorders. Therefore, treatment differ considerably depending on the underlying cause. Our aim was to assess the administered treatment and therapeutic response in a wide series of patients with aortitis and periaortitis from a single reference University center. Methods Retrospective and observational study of patients with aortitis and/or periaortitis from a referral center in Northern Spain. The main outcomes include: clinical remission (absence of clinical symptoms), complete remission (absence of clinical symptoms and analytical normalization), and imaging remission (absence of clinical symptoms and normalization of imaging alterations). Safety data during evolution were also evaluated. Results We included 134 patients (87 female/47 male) (mean age: 55.1 ± 9.1 years) with 132 aortitis and 2 periaortitis. The main diagnostic method was the positron emission tomography (PET), showing a non-specific increased of ¹⁸ F-FDG uptake of aorta with/without its major branches. The patients were treated with: glucocorticoids (n = 128; 95.5%), conventional immunosuppressive drugs (n = 68; 50.7%), biological therapy (n = 48; 35.8%), antibiotics (n = 3; 2.2%), and surgery (n = 6; 4.5%). After a mean follow-up of 39.2 ± 26.7 months, 75 patients (56%) experimented clinical remission, 65 (48.5%) complete remission and only 14 (10.4%) imaging remission. Conclusion Aortitis and periaortitis are conditions which require an early diagnosis and treatment. Glucocorticoids are the first line of treatment in patients with non-infectious aortitis or periaortitis. ¹⁸ F-FDG PET/CT scan is a useful imaging technique to evaluate the disease activity and response to therapy.