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

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Giant cell arteritis : A nationwide, population-based cohort study on incidence, diagnostic imaging, and glucocorticoid treatment. / Therkildsen, Philip; de Thurah, Annette; Hansen, Ib Tønder; Nørgaard, Mette; Nielsen, Berit Dalsgaard; Hauge, Ellen Margrethe.

In: Seminars in Arthritis and Rheumatism, Vol. 51, No. 2, 04.2021, p. 360-366.

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@article{8904e9f18e6141edb98d8508df8d8ea4,
title = "Giant cell arteritis: A nationwide, population-based cohort study on incidence, diagnostic imaging, and glucocorticoid treatment",
abstract = "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.",
keywords = "Epidemiology, Giant cell arteritis, Glucocorticoids, Imaging, Incidence, Temporal Artery biopsy",
author = "Philip Therkildsen and {de Thurah}, Annette and Hansen, {Ib T{\o}nder} and Mette N{\o}rgaard and Nielsen, {Berit Dalsgaard} and Hauge, {Ellen Margrethe}",
year = "2021",
month = apr,
doi = "10.1016/j.semarthrit.2021.01.007",
language = "English",
volume = "51",
pages = "360--366",
journal = "Seminars in Arthritis and Rheumatism",
issn = "0049-0172",
publisher = "W.B. Saunders Co.",
number = "2",

}

RIS

TY - JOUR

T1 - Giant cell arteritis

T2 - A nationwide, population-based cohort study on incidence, diagnostic imaging, and glucocorticoid treatment

AU - Therkildsen, Philip

AU - de Thurah, Annette

AU - Hansen, Ib Tønder

AU - Nørgaard, Mette

AU - Nielsen, Berit Dalsgaard

AU - Hauge, Ellen Margrethe

PY - 2021/4

Y1 - 2021/4

N2 - 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.

AB - 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.

KW - Epidemiology

KW - Giant cell arteritis

KW - Glucocorticoids

KW - Imaging

KW - Incidence

KW - Temporal Artery biopsy

UR - http://www.scopus.com/inward/record.url?scp=85101053074&partnerID=8YFLogxK

U2 - 10.1016/j.semarthrit.2021.01.007

DO - 10.1016/j.semarthrit.2021.01.007

M3 - Journal article

C2 - 33601192

VL - 51

SP - 360

EP - 366

JO - Seminars in Arthritis and Rheumatism

JF - Seminars in Arthritis and Rheumatism

SN - 0049-0172

IS - 2

ER -