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Giant cells in temporal artery biopsies and the risk of large-vessel involvement in patients with giant cell arteritis

Naderi, Nazanin LU orcid ; Mohammad, Aladdin J. LU ; Wadström, Karin LU and Turesson, Carl LU (2025) In Clinical and Experimental Rheumatology 43(4). p.587-594
Abstract

Objective Giant cell arteritis (GCA) is a systemic disease with variable vascular involvement. The objective was to investigate predictors of time-dependent large-vessel involvement (LVI) in a population-based cohort of patients with GCA. Methods GCA patients with positive temporal artery biopsies (TAB) between 1997- 2010 were identified through a regional pathology register. A structured review of histopathology reports and relevant imaging studies was performed. Cases with LVI through July 2016 were identified. Patients were followed to first LVI, death, migration from the area or July 29, 2016. Event free survival by clinical and histopathologic features was estimated using the Kaplan-Meier method. Potential predictors of LVI were... (More)

Objective Giant cell arteritis (GCA) is a systemic disease with variable vascular involvement. The objective was to investigate predictors of time-dependent large-vessel involvement (LVI) in a population-based cohort of patients with GCA. Methods GCA patients with positive temporal artery biopsies (TAB) between 1997- 2010 were identified through a regional pathology register. A structured review of histopathology reports and relevant imaging studies was performed. Cases with LVI through July 2016 were identified. Patients were followed to first LVI, death, migration from the area or July 29, 2016. Event free survival by clinical and histopathologic features was estimated using the Kaplan-Meier method. Potential predictors of LVI were examined using Cox regression models. Results A total of 274 patients were included. The mean age at GCA diagnosis was 75.7 years. Fifty-one patients (19 %) had documented LVI during the follow-up, corresponding to an incidence rate of 2.4/100 person-years. The median time from GCA diagnosis to the diagnosis of LVI was 4.5 years (interquartile range 0.6-7.4). Thirty-four patients had aortic involvement (67% of those with LVI; 12% of all GCA cases). Survival free of LVI was longer in patients with giant cells in the TAB (75th percentile 14.0 vs 6.7 years; p=0.014). In age-adjusted analysis, the presence of giant cells in the TAB was associated with reduced risk of LVI (hazard ratio 0.48; 95 % confidence interval 0.27-0.86). Conclusion The negative association with giant cells in the TAB suggests that patients with LVI constitute a subset of GCA with particular disease mechanisms.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
aortitis, giant cell arteritis, temporal arteritis
in
Clinical and Experimental Rheumatology
volume
43
issue
4
pages
8 pages
publisher
Pacini
external identifiers
  • pmid:38976299
  • scopus:105002986106
ISSN
0392-856X
DOI
10.55563/clinexprheumatol/lygms4
language
English
LU publication?
yes
id
40106ffe-2442-4e9b-99f4-b7e44cf3e6df
date added to LUP
2025-08-08 11:59:23
date last changed
2025-08-08 12:00:17
@article{40106ffe-2442-4e9b-99f4-b7e44cf3e6df,
  abstract     = {{<p>Objective Giant cell arteritis (GCA) is a systemic disease with variable vascular involvement. The objective was to investigate predictors of time-dependent large-vessel involvement (LVI) in a population-based cohort of patients with GCA. Methods GCA patients with positive temporal artery biopsies (TAB) between 1997- 2010 were identified through a regional pathology register. A structured review of histopathology reports and relevant imaging studies was performed. Cases with LVI through July 2016 were identified. Patients were followed to first LVI, death, migration from the area or July 29, 2016. Event free survival by clinical and histopathologic features was estimated using the Kaplan-Meier method. Potential predictors of LVI were examined using Cox regression models. Results A total of 274 patients were included. The mean age at GCA diagnosis was 75.7 years. Fifty-one patients (19 %) had documented LVI during the follow-up, corresponding to an incidence rate of 2.4/100 person-years. The median time from GCA diagnosis to the diagnosis of LVI was 4.5 years (interquartile range 0.6-7.4). Thirty-four patients had aortic involvement (67% of those with LVI; 12% of all GCA cases). Survival free of LVI was longer in patients with giant cells in the TAB (75<sup>th</sup> percentile 14.0 vs 6.7 years; p=0.014). In age-adjusted analysis, the presence of giant cells in the TAB was associated with reduced risk of LVI (hazard ratio 0.48; 95 % confidence interval 0.27-0.86). Conclusion The negative association with giant cells in the TAB suggests that patients with LVI constitute a subset of GCA with particular disease mechanisms.</p>}},
  author       = {{Naderi, Nazanin and Mohammad, Aladdin J. and Wadström, Karin and Turesson, Carl}},
  issn         = {{0392-856X}},
  keywords     = {{aortitis; giant cell arteritis; temporal arteritis}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{587--594}},
  publisher    = {{Pacini}},
  series       = {{Clinical and Experimental Rheumatology}},
  title        = {{Giant cells in temporal artery biopsies and the risk of large-vessel involvement in patients with giant cell arteritis}},
  url          = {{http://dx.doi.org/10.55563/clinexprheumatol/lygms4}},
  doi          = {{10.55563/clinexprheumatol/lygms4}},
  volume       = {{43}},
  year         = {{2025}},
}