scholarly journals Vascular Ultrasound for Giant Cell Arteritis: Establishing a Protocol Using Vascular Sonographers in a Fast‐Track Clinic in the United States

2021 ◽  
Author(s):  
Charles Oshinsky ◽  
Alison M. Bays ◽  
Ingeborg Sacksen ◽  
Elizabeth Jernberg ◽  
R. Eugene Zierler ◽  
...  
Keyword(s):  
United States ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Fast Track ◽  
The United States ◽  
Vascular Ultrasound

scholarly journals Estimating the Cost of Illness of Giant Cell Arteritis in the United States

2017 ◽  
Vol 4 (1) ◽  
pp. 111-119 ◽  
Author(s):  
Joseph B. Babigumira ◽  
Meng Li ◽  
Denise M. Boudreau ◽  
Jennie H. Best ◽  
Louis P. Garrison
Keyword(s):  
United States ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Cost Of Illness ◽  
The United States ◽  
The Cost

scholarly journals Projected Worldwide Disease Burden from Giant Cell Arteritis by 2050

2014 ◽  
Vol 42 (1) ◽  
pp. 119-125 ◽  
Author(s):  
Elisabeth De Smit ◽  
Andrew J. Palmer ◽  
Alex W. Hewitt
Keyword(s):  
United States ◽  
Visual Impairment ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Visually Impaired ◽  
Disease Burden ◽  
Science Studies ◽  
The United States ◽  
Population Projections ◽  
Incident Cases

Objective.To estimate and project the number of people affected worldwide by giant cell arteritis (GCA) by 2050. Modeling the number of people visually impaired as a result of this disease will help establish the projected morbidity and resource burden.Methods.A systematic literature review up to December 2013 was conducted using PubMed and ISI Web of Science. Studies reporting an incidence rate for GCA were used to model disease incident cases at regional and national levels. United Nations Population Prospect data were used for population projections. Morbidity burden was established through rates of visual impairment. The associated financial implications were calculated for the United States.Results.The number of incident cases of GCA will increase secondary to an aging population. By 2050, more than 3 million people will have been diagnosed with GCA in Europe, North America, and Oceania. About 500,000 people will be visually impaired. By 2050, in the United States alone, the estimated cost from visual impairment due to GCA will exceed US$76 billion. Inpatient care for patients with active GCA will total about US$1 billion. Management of steroid-related adverse events will increase costs further, with steroid-induced fractures estimated to total US$6 billion by 2050.Conclusion.Projecting disease burden for GCA on a global scale allows for optimization of healthcare planning and prioritization of research domains. Additional population-based studies are required to more accurately project worldwide disease burden. Our work highlights the future global disease burden of GCA, and illustrates the associated financial implications.

scholarly journals OP0150 WHAT IS THE ROLE OF TEMPORAL ARTERY BIOPSY IN GIANT CELL ARTERITIS FAST-TRACK PATHWAYS WHEN TEMPORAL ARTERY ULTRASOUND IS NEGATIVE?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 95.3-95
Author(s):  
A. Sachdev ◽  
S. Dubey ◽  
C. Tiivas ◽  
M. George ◽  
P. Mehta
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Sensitivity And Specificity ◽  
Fast Track ◽  
Temporal Artery ◽  
Clinical Findings ◽  
Specimen Size ◽  
Temporal Artery Biopsy ◽  
Duration Of Treatment ◽  
Relevant Role

Background:A number of centres are now running fast track pathways for diagnosis and management of Giant cell arteritis with ultrasound as the first port of call for diagnosis1. Temporal artery biopsies (TABs) have become the second line of investigation, and it is unclear how useful TAB is in this setting.Objectives:This study looked at accuracy of Temporal artery biopsy (TAB) in patients with suspected Giant Cell arteritis (GCA) with negative/inconclusive ultrasound (U/S) and how duration of treatment on steroids prior to these investigations and arterial specimen size affected it.Methods:Prospective study of all patients with suspected GCA referred for TAB when U/S was negative or inconclusive, as part of the local fast-track pathway (Coventry). Database included clinical findings, serological work up, U/S and TAB results and treatment. Sensitivity and specificity of U/S and TAB was calculated and compared based on duration of treatment with steroids.Results:One hundred and nine patients were referred for TAB via Coventry fast-track-pathway. The sensitivity of U/S in this cohort of patients was 9.08% and specificity was 93.33%. After 3 days of steroid this was 0% and 100% respectively. For TAB when done within 10 days of starting steroids, this was 65% and 87.5% respectively. After 20 days of steroids this was 0 % and 100%. The sensitivity and specificity was 20% and 85% when arterial specimen size was 11-15mm and 47% and 100% when specimen size was 16 mm or more. Sensitivity and specificity of U/S of 644 suspected GCA patients was 48% and 98%.Conclusion:Our study demonstrates that TAB plays a relevant role in GCA fast-track-pathways, when U/S is negative/inconclusive. TAB was more sensitive than U/S in this cohort of patients, but overall sensitivity of U/S was higher when calculated for all patients suspected with GCA. Both remain useful tests if performed early. TAB specimen size should ideally be 16mm or more and done within 10 days of starting steroids.References:[1]Jonathan Pinnell, Carl Tiivas, Kaushik Chaudhuri, Purnima Mehta, Shirish Dubey, O38 The diagnostic performance of ultrasound Doppler in a fast-track pathway for giant cell arteritis,Rheumatology, Volume 58, Issue Supplement_3, April 2019, kez105.036,https://doi.org/10.1093/rheumatology/kez105.036Disclosure of Interests:None declared

scholarly journals POS0821 THE DIFFERENT SUBTYPES OF GIANT CELL ARTERITIS BY ULTRASOUND: RESULTS FROM A FAST-TRACK CLINIC

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 664.3-664
Author(s):  
I. Monjo ◽  
E. Fernández-Fernández ◽  
J. Ortega ◽  
E. De Miguel
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Fast Track ◽  
Carotid Arteries ◽  
Imaging Techniques ◽  
Vascular Involvement ◽  
Temporal Arteries ◽  
Halo Sign ◽  
Cranial Vessels ◽  
Large Vessels

Background:Giant cell arteritis (GCA) is a vasculitis that affects the medium and large vessels (LV). Although cranial artery involvement is better known, awareness of the importance of LV involvement is increasing. Imaging techniques currently constitute the basis for the diagnosis of LV-GCA and have improved its diagnosis and prevalence. In recent years, differences in clinical patterns and different inflammatory and etiopathogenic mechanisms of the disease have been suggested. Therefore, improving sensitivity to diagnosis is essential to improve the knowledge and care of our population.Objectives:The aim of this study was to know the prevalence of the different ultrasound patterns of GCA in our area.Methods:Retrospective records of available data were collected from all patients referred to our ACG fast track clinic in the past three years. The clinical and laboratory characteristics were evaluated at the time of referral. All patients underwent an ultrasound scan of cranial vessels (superficial temporal arteries (TA) and their frontal and parietal branches) and large vessels (axillary, subclavian and carotid arteries). The doctor confirmed the GCA diagnosis after at least six months of follow-up. The OMERACT definitions of halo sign with a hypoechoic wall thickness ≥ 0.34 mm were used for TA pathology for the ultrasound diagnosis of GCA and for axillary, subclavian and carotid arteries and homogeneous hypoechoic thicknesses ≥ 1 mm of the arterial wall were applied. Atherosclerosis lesions were evaluated to detect this disease as a possible false positive halo sign. An Esaote Mylab Twice with a 13 MHz probe in BT and 22 MHz for cranial vessels in 2017-2019 and an Esaote Mylab X8plus with a 15 MHz probe for BT and a 24 MHz probe for cranial arteries in 2019-2020 were used by two rheumatologist with long experience in ACG ultrasound.Results:A total of 261 patients (180 women / 81 men) with suspected GCA were evaluated in our fast track clinic. The mean age (± SD) was 76 ± 9.2 years and CRP at diagnosis was 75.7 ± 68.6 mg/L. The time elapsed since the first symptoms was less than 6, 6-12, 12-24 or >24 weeks in 37.5%, 19.9%, 12.3% and 15.7% respectively. Of the 261 cases explored, 160 had GCA, of which 102 were women and 58 men, and had a mean age of 77.21 ± 7.9 years. The ultrasound patterns of GCA were: 71 patients had exclusive involvement of the TA (cranial-GCA), 54 had a mixed pattern with involvement of both TA and LV (mixed-CGA), and 35 had isolated involvement of the LV (LV-GCA). That is, 125 patients had cranial involvement with or without LV involvement and 89 had LV-GCA associated or not with cranial involvement (Figure 1).Figure 1.Ultrasound patters of GCAConclusion:Ultrasound is a useful tool for the screening of GCA and its different subtypes of vascular involvement. The isolated cranial subtype or associated with LV-GCA is the most common (78% of cases), but LV-GCA is also very common (55.6% of cases of GCA) and 21.9% presents as an isolated LV-GCA standard. The LV arteries should be included in the ultrasound examination for suspected GCA.Disclosure of Interests:Irene Monjo Speakers bureau: Roche, Novartis, UCB, Gedeon Richter, Consultant of: Roche, Elisa Fernández-Fernández: None declared, Javier Ortega: None declared, Eugenio de Miguel Speakers bureau: AbbVie, Novartis, Pfizer, MSD, BMS, UCB, Roche, Grunental, Janssen, Sanofi, Paid instructor for: Janssen, Novartis, Roche, Consultant of: AbbVie, Novartis, Pfizer, Galapagos, Grant/research support from: Abbvie, Novartis, Pfizer

The role of vascular ultrasound in managing giant cell arteritis in ophthalmology

2020 ◽  
Vol 65 (2) ◽  
pp. 218-226
Author(s):  
Jared Ching ◽  
Sonja Mansfield Smith ◽  
Bhaskar Dasgupta ◽  
Erika Marie Damato
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Vascular Ultrasound

scholarly journals 339. COVENTRY FAST-TRACK GIANT CELL ARTERITIS PATHWAY WITH WALK-IN ULTRASOUND: 3 YEAR DATA

Rheumatology ◽  
2017 ◽  
Vol 56 (suppl_2) ◽  
Author(s):  
Shirish Dubey ◽  
Carl Tiivas ◽  
Matthew George ◽  
Purnima Mehta
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Fast Track
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