Giant cell arteritis: A nationwide, population-based cohort study on incidence, diagnostic imaging, and glucocorticoid treatment

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Aim: The study investigated the development over time of the incidence, diagnostic imaging, and treatment of giant cell arteritis (GCA). Method: This nationwide, population-based cohort study was conducted in Denmark using medical and administrative registries. Incident GCA cases from 1996–2018 were defined as patients aged ≥50 years registered with a first-time GCA diagnosis and ≥3 prescriptions for glucocorticoids (GCs) within 6 months after diagnosis. We determined incidence rates of GCA, the proportion of patients still receiving GCs >2 years after diagnosis, the proportion of patients receiving temporal artery biopsies (TAB) and diagnostic imaging including ultrasound, positron emission tomography, magnetic resonance, and/or computed tomography angiography at the time of diagnosis. Results: We identified 9908 incident GCA cases. The incidence rates of GCA remained stable at 19–25 per 100,000 people aged >50 years from 1996–2018. The proportion of GCA patients receiving a TAB remained constant until 2016, after which it promptly declined from 70–80% to 29–39%. In contrast, the proportion of patients receiving diagnostic imaging increased from 2% to 66% from 2000–2018. The proportion of GCA patients remaining in GC treatment has steadily decreased from 1996–2016, but remains high at 64%, 40%, and 34% after 2, 5, and 10 years following the diagnosis, respectively. The cumulative GC dose has remained relatively stable. Conclusion: Incidence rates of GCA have remained stable since 1996 despite increasing use of diagnostic imaging. There is a clear discrepancy between current international GCA treatment guidelines and the clinical practice up to 2018.

Original languageEnglish
JournalSeminars in Arthritis and Rheumatism
Volume51
Issue2
Pages (from-to)360-366
Number of pages7
ISSN0049-0172
DOIs
Publication statusPublished - Apr 2021

    Research areas

  • Epidemiology, Giant cell arteritis, Glucocorticoids, Imaging, Incidence, Temporal Artery biopsy

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