Vasculitis & polymyalgia rheumatica
Performance of the modified 2022 ACR/EULAR giant cell arteritis classification criteria without age restriction for discriminating from Takayasu arteritis
Authors' conclusion
The modified 2022 ACR/EULAR GCA classification criteria well performed in classifying GCA and TAK without PET-CT in routine clinical practice. A set of items included in the modified GCA classification criteria had good discriminative ability for GCA and TAK, even when age was excluded. However, age restriction or PMR was required to distinguish GCA without cranial lesions from TAK.
Study context
- Population
- Newly diagnosed patients with giant cell arteritis (GCA) or TAK enrolled in a Japanese nationwide retrospective registry
- Participants
- 139 vs 129
- Comparison
- Modified 2022 ACR/EULAR GCA classification criteria (score ≥ 6) in GCA vs TAK as controls
- GCAn = 139
- TAKn = 129reference
- Outcome
- Discriminability of GCA from TAK by the modified 2022 ACR/EULAR GCA classification criteria (C-statistic; > 0.7: good ability)
Methodological detailsJapanese nationwide retrospective registry, modified criteria: aortic wall thickening by contrast-enhanced computed tomography (CT) or MRI instead of PET-CT
- Japanese nationwide retrospective registry
- Modified criteria: aortic wall thickening by contrast-enhanced CT or MRI instead of PET-CT
Performance
As reported in the abstract
C-statistic
0.986
95% CI 0.976–0.996
full criteria
C-statistic
0.927
95% CI 0.894–0.961
after excluding age
Further findings
Discriminability of the criteria after excluding age
- C-statistic after excluding age (remained good)
- 0.927, 95% CI: 0.894-0.961
- C-statistic > 0.7: good ability
Discriminability of item sets: large-vessel lesions (bilateral axillary artery and descending thoracic-abdominal aorta)
- Large-vessel lesions + inflammatory markers: C-statistic (markedly decreased, poor)
- 0.598, 95% CI: 0.530-0.667
- Large-vessel lesions + polymyalgia rheumatica (PMR): C-statistic (improved)
- 0.757, 95% CI: 0.700-0.813
- Large-vessel lesions + age: C-statistic (improved)
- 0.913, 95%CI: 0.874-0.951
Late-onset TAK meeting the modified criteria
- Late-onset TAK patients meeting the modified criteria
- 5
- Of these, with cranial signs and symptoms
- 4
- Of these, with bilateral axillary artery involvement
- 2
- Of these, with descending thoracic-abdominal aorta involvement
- 4
Bilateral subclavian and/or axillary artery involvement in GCA with score ≤ 5
- GCA with score ≤ 5 having bilateral subclavian and/or axillary artery involvement
- 52%
Original publication
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