Giant cell arteritis-related aortitis with positive or negative temporal artery biopsy: a French multicentre study

Agard, C.; Bonnard, G.; Samson, M.; Moreuil, Claire de; Lavigne, Christian; Jégo, Patrick; Connault, J.; Artifoni, Mathieu; Gallou, Thomas Le; Landron, C.; Roblot, P.; Magnant, Julie; Bélizna, C.; Maillot, F.; Diot, Élisabeth; Néel, A.; Hamidou, M.; Espitia, O.

doi:10.1080/03009742.2019.1661011

Cited by 8 publications

(16 citation statements)

References 40 publications

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“…Among patients with GCA-related aortitis, our group already showed that diffuse arterial involvement from the aortic arch was more frequent in temporal artery biopsy (TAB)-patients (29.1 versus 8.9%, p = 0.03), compared with those with positive TAB. 27 In this study, a positive TAB was associated with a lower relapse rate.…”

Section: Discussionsupporting

confidence: 49%

“…Many of them have been the subject of a standardized collection of disease characteristics since the initiation of our center’s research studies in 1998. 2 , 22 , 25 – 27 We collected 247 parameters, including demographic features, comorbid conditions, systemic and associated GCA symptoms like PMR meeting the European League Against Rheumatism (EULAR) criteria, 28 or any other peripheral musculoskeletal manifestations not meeting PMR criteria (peripheral arthritis/synovitis, polyarthritis/polyarthralgia, myalgia, or rheumatoid arthritis meeting the ACR criteria, 29 extremity swelling with or without pitting edema, distal tenosynovitis) but improving under corticosteroids. A GCA cranial involvement was defined by the presence of headaches, and/or temporal artery tenderness or swelling, and/or jaw claudication, and/or scalp tenderness and/or ophthalmological signs of GCA.…”

Section: Methodsmentioning

confidence: 99%

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Large-vessel involvement is predictive of multiple relapses in giant cell arteritis

Mornac

Espitia

Néel

et al. 2021

Therapeutic Advances in Musculoskeletal

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Background: Giant cell arteritis (GCA) is the most common systemic vasculitis. Relapses are frequent. The aim of this study was to identify relapse risk factors in patients with GCA with complete large-vessel imaging at diagnosis. Methods: Patients with GCA followed in our institution between April 1998 and April 2018 were included retrospectively. We included only patients who had undergone large vascular imaging investigations at diagnosis by computed tomography (CT)-scan and/or positron emission tomography (PET)-scan and/or angio-magnetic resonance imaging (MRI). Clinical, biological, and radiological data were collected. Relapse was defined as the reappearance of GCA symptoms, with concomitant increase in inflammatory markers, requiring treatment adjustment. Relapsing patients (R) and non-relapsing patients (NR) were compared. Relapse and multiple relapses (>2) risk factors were identified in multivariable Cox analyses. Results: This study included 254 patients (73.2% women), with a median age of 72 years at diagnosis and a median follow up of 32.5 months. At diagnosis, 160 patients (63%) had an inflammatory large-vessel involvement on imaging, 46.1% (117 patients) relapsed at least once, and 21.3% (54 patients) had multiple relapses. The median delay of first relapse after diagnosis was 9 months. The second relapse delay was 21.5 months. NR patients had more stroke at diagnosis than R ( p = 0.03) and the brachiocephalic trunk was involved more frequently on CT-scan ( p = 0.046), as carotids ( p = 0.02) in R patients. Multivariate Cox model identified male gender [hazard ratio (HR): 0.51, confidence interval (CI) (0.27–0.96), p = 0.04] as a relapse protective factor, and peripheral musculoskeletal manifestations [HR: 1.74 (1.03–2.94), p = 0.004] as a relapse risk factor. Peripheral musculoskeletal manifestations [HR: 2.78 (1.23–6.28), p = 0.014], negative temporal artery biopsy [HR: 2.29 (1.18–4.45), p = 0.015], large-vessel involvement like upper limb ischemia [HR: 8.84 (2.48–31.56), p = 0.001] and inflammation of arm arteries on CT-scan [HR: 2.39 (1.02–5.58), p = 0.04] at diagnosis were risk factors of multiple relapses. Conclusion: Male gender was a protective factor for GCA relapse and peripheral musculoskeletal manifestations appeared as a relapsing risk factor. Moreover, this study identified a particular clinical phenotype of multi-relapsing patients with GCA, characterized by peripheral musculoskeletal manifestations, negative temporal artery biopsy, and large-vessel involvement with upper limb ischemia or inflammation of arm arteries. Plain language Summary At giant cell arteritis diagnosis, large-vessel inflammatory involvement is predictive of multiple relapses 46.1% of patients with GCA relapse, and 21.3% undergo multiple relapses; Male gender appears as a protective factor for relapsing in GCA; Peripheral musculoskeletal manifestations are a relapse and multiple relapses risk factor; A negative temporal artery biopsy is predictive of multiple relapses; Large-vessel involvement is predictive of multiple relapses.

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Section: Discussionsupporting

confidence: 49%

Section: Methodsmentioning

confidence: 99%

Large-vessel involvement is predictive of multiple relapses in giant cell arteritis

Mornac

Espitia

Néel

et al. 2021

Therapeutic Advances in Musculoskeletal

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“…Of the 13 studies, five 11 , 13 , 17 , 19 , 21 reported mean erythrocyte sedimentary rate (ESR) (in mm/hour) with a weighted average of 83.2 in the biopsy positive group, and 71.1 in the negative biopsy group. Five studies reported TAB mean length for both groups (Table 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…2 Thirteen studies herein reported reflect that clinicians do not alter steroid duration based on TAB result. 1,[10][11][12][13][14][15][16][17][18][19][20][21]…”

Section: Discussionmentioning

confidence: 99%

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Necessity of Temporal Artery Biopsy for Giant Cell Arteritis: A Systematic Review

Ponich

Hartley

Lafrenière

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Temporal artery biopsy (TAB) is currently the gold standard procedure to diagnose giant cell arteritis. Despite low sensitivity, TAB is routinely performed even if a clinical diagnosis has already been made. The objective of this study was to determine the usefulness of TAB for giant cell arteritis management. Methods: We performed a systematic review to identify studies that compared steroid treatment between TAB+ and TAB− patients. EMBASE, MEDLINE, and the Cochrane Central Register of Controlled Trials were searched from inception until April 4, 2020. Titles, abstracts, and full texts were reviewed by two independent reviewers and conflicts resolved by consensus. Studies reporting TAB result and steroid treatment were included. Information pertaining to steroid treatment was compared between TAB+ and TAB− groups. Steroid duration was compared by grouping patients in a less than 6 month group, a 6–24 month group, and a more than 24 month group. Results: An estimated 5288 abstracts were screened and 13 studies involving 1355 patients were included. Rate of prebiopsy steroid treatment was higher in TAB+ patients compared with TAB− patients [93% versus 63% (P < 0.001)]. The TAB+ group was more likely to be started on steroids prebiopsy [28% versus 8% (P < 0.001)]. TAB+ and TAB− patients had similar steroid duration for all groups [<6-month group 17% versus 19% (P-0.596), the 6-24-month group 16% versus 19% (P-0.596), and the >24-month group 66% versus 63% (P-0.642)]. Conclusion: TAB results have minimal impact on treatment, and the utility should be reconsidered when a clinical diagnosis of giant cell arteritis is possible.

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Clinical phenotype and complications of large vessel giant cell arteritis: A systematic review and meta-analysis

et al. 2023

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Giant cell arteritis-related aortitis with positive or negative temporal artery biopsy: a French multicentre study

Cited by 8 publications

References 40 publications

Large-vessel involvement is predictive of multiple relapses in giant cell arteritis

Large-vessel involvement is predictive of multiple relapses in giant cell arteritis

Necessity of Temporal Artery Biopsy for Giant Cell Arteritis: A Systematic Review

Clinical phenotype and complications of large vessel giant cell arteritis: A systematic review and meta-analysis

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