Influence of the EULAR recommendations for the use of imaging in large vessel vasculitis in the diagnosis of giant cell arteritis: results of the ARTESER register
Por:
De Miguel, E, Sanchez-Costa, JT, Estrada, P, Munoz, A, Martinez, CV, Alvarado, PM, Garcia-Villanueva, MJ, Angeles, VAN, Da Veiga, CGL, Frutos, AR, Ivorra, JAR, Arrabal, SL, Rocha, MV, Iniguez, CL, Garcia-Gonzalez, M, Molina-Almeda, C, Villar, MA, Mas, AJ, Gonzalez-Gay, MA, Blanco, R
Publicada:
1 dic 2022
Resumen:
ObjectiveThe main study objective was to determine how giant cell arteritis (GCA) is diagnosed in our clinical practice and whether the EULAR recommendations have influenced the diagnostic procedures used.MethodsARTEritis of the Rheumatology Spanish Society -Sociedad Espanola de Reumatologia (ARTESER) is a multicentre observational retrospective study conducted in 26 hospitals with support from the Spanish Society of Rheumatology. All patients diagnosed with GCA between 1 June 2013 and 29 March 2019 were included. The gold standard for the diagnosis of GCA was the judgement of the physician in charge, according to clinical criteria, supported by data available from laboratory tests, imaging studies (ultrasound, positron emission tomography (PET) and MRI/CT angiography) and temporal artery biopsy (TAB) when available.ResultsWe included 1675 patients with GCA (mean age +/- SD (76.9 +/- 8.1) years, 1178 women (70.3%)). Of these, 776 patients had a positive TAB (46.3%), 503 (30.0%) positive ultrasound, 245 positive PET (14.6%) and 64 positive MRI/CT angiography (3.8%). These percentages changed substantially over the study. From 2013 to 2019, the use of ultrasound in diagnosis grew from 25.8% to 52.9% and PET from 12.3% to 19.6%, while use of TAB decreased from 50.3% to 33.3%.ConclusionsBiopsy was the most widely used diagnostic test for confirming GCA, but use of imaging as a diagnostic tool has grown in recent years. Following publication of the 2018 EULAR recommendations, ultrasound has displaced biopsy as the first-line diagnostic test; TAB was performed in a third and PET in a fifth of cases.
Filiaciones:
De Miguel, E:
Hosp Univ La Paz, Madrid, Spain
Sanchez-Costa, JT:
Res Unit, Rheumatol, Madrid, Spain
Estrada, P:
Hosp St Joan Despi Moises Broggi, Rheumatol Dept, St Joan Despi, Spain
Munoz, A:
Hosp Univ Virgen Rock Sevilla, Rheumatol Dept, Seville, Spain
Martinez, CV:
Hosp Univ Princesa, Rheumatol Dept, Madrid, Spain
Alvarado, PM:
Hosp Santa Creu & St Pau Barcelona, Rheumatol Dept, Barcelona, Spain
Garcia-Villanueva, MJ:
Hosp Univ Ramon y Cajal, Madrid, Spain
Angeles, VAN:
Hosp St Joan Despi Moises Broggi, Rheumatol Dept, St Joan Despi, Spain
Da Veiga, CGL:
Hosp Univ Parc Tauli Sabadell, Rheumatol Dept, Sabadell, Spain
Frutos, AR:
Hosp Badalona Germans Trias & Pujol, Rheumatol Dept, Badalona, Spain
Ivorra, JAR:
Hosp Univ & Politecn La Fe, Rheumatol Dept, Valencia, Spain
Arrabal, SL:
Hosp Mar, Rheumatol Dept, Barcelona, Spain
Rocha, MV:
Hosp Univ Araba, Rheumatol Dept, Vitoria, Spain
Iniguez, CL:
Hosp Univ Lucus Augusti, Rheumatol, Lugo, Galicia, Spain
Garcia-Gonzalez, M:
Hosp Univ Canarias, San Cristobal la Laguna, Canarias, Spain
Molina-Almeda, C:
Consorci Hosp Gen Univ Valencia, Rheumatol, Valencia, Comunitat Valen, Spain
Villar, MA:
Hosp Univ Severo Ochoa Leganes, Rheumatol Dept, Madrid, Spain
Mas, AJ:
Hosp Univ Son Llatzer, Rheumatol Dept, Palma De Mallorca, Spain
Gonzalez-Gay, MA:
Hosp Univ Marques Valdecilla, IDIVAL, Rheumatol, Santander, Cantabria, Spain
Blanco, R:
Hosp Univ Marques Valdecilla, IDIVAL, Rheumatol, Santander, Cantabria, Spain
Green Published, gold, All Open Access, Gold, Green
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