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

Abstract

Objective: To compare the clinical presentation and outcome of giant cell arteritis (GCA)-related aortitis according to the results of temporal artery biopsy (TAB).

Method: Patients with GCA-related aortitis diagnosed between 2000 and 2017, who underwent TAB, were retrospectively included from a French multicentre database. They all met at least three American College of Rheumatology criteria for the diagnosis of GCA. Aortitis was defined by aortic wall thickening > 2 mm on computed tomography scan and/or an aortic aneurysm, associated with an inflammatory syndrome. Patients were divided into two groups [positive and negative TAB (TAB+, TAB−)], which were compared regarding aortic imaging characteristics and aortic events, at aortitis diagnosis and during follow-up.

Results: We included 56 patients with TAB+ (70%) and 24 with TAB− (30%). At aortitis diagnosis, patients with TAB− were significantly younger than those with TAB+ (67.7 ± 9 vs 72.3 ± 7 years, p = 0.022). Initial clinical signs of GCA, inflammatory parameters, and glucocorticoid therapy were similar in both groups. Coronary artery disease and/or lower limb peripheral arterial disease was more frequent in TAB− patients (25% vs 5.3%, p = 0.018). Aortic wall thickness and type of aortic involvement were not significantly different between groups. Diffuse arterial involvement from the aortic arch was more frequent in TAB− patients (29.1 vs 8.9%, p = 0.03). There were no differences between the groups regarding overall, aneurism-free, relapse-free, and aortic event-free survival.

Conclusion: Among patients with GCA-related aortitis, those with TAB− are characterized by younger age and increased frequency of diffuse arterial involvement from the aortic arch compared to those with TAB+, without significant differences in terms of prognosis.

Acknowledgement

We acknowledge the French Large Vessel Vasculitis Study Group (Groupe d’Etude Français des Artérites des gros vaisseaux).

Disclosure statement

No potential conflict of interest was reported by the authors.