Giant Cell Arteritis Screening Tools Effectively Prevent Unnecessary Biopsy

Giant cell arteritis (GCA) screening and immediate treatment can stave off sudden vision loss. For that reason, the application of accurate screening tools is paramount. Both the Edsel Ing GCA risk calculator and the Weis Prediction Model can be valuable options for  giant cell arteritis screening, according to a poster presented at the North American Neuro-Ophthalmology Society (NANOS) 49th annual meeting held in Orlando, FL, March 11-16, 2023. Although temporal artery biopsy is the gold standard for GCA diagnosis, these invasive procedures may miss pathological findings. These prediction models could help avoid unnecessary testing and improve the effective use of health care resources.

While early intervention is vital for these patients, treatment often involves systemic glucocorticoids, which have many potential side effects. “A system to accurately triage those very unlikely to have GCA can help to avoid steroid-associated morbidity,” according to the presenters, Hamza Inayat, Saerom Youn, MD, MSc, and Lulu Bursztyn MD, MSc.

The researchers evaluated 5 years worth of data for 155 eligible patients (mean [SD] age, 73[9] years; 78.1% women) who underwent temporal artery biopsy for giant cell arteritis screening. Biopsies were negative for GCA in 100 patients (64.5%), and positive in 42 patients (27.1%). Of those, 12 patients who had negative biopsies were clinically diagnosed with GCA. 

The research team took the patient data collected through chart review — age, sex, GCA symptoms, C-reactive protein, erythrocyte sedimentation rate, and platelets — and retroactively entered it into 3 prediction model calculators designed to optimize giant cell arteritis screening. They then compared the results to biopsy findings and clinical diagnoses to determine if biopsies could be avoided where there was preoperative certainty of the result.

The prediction models included The Ing Risk Calculator, The González-López GCA Risk Calculator, and the Weis Prediction Model. 

The investigation shows that 41 biopsies (28.9%) could have been avoided using the Ing Calculator, 9 (6.34%) using the González-López Calculator, and 28 (19.7%) using the Weis Prediction Model.

“The findings suggest that the Edsel Ing GCA Risk calculator and the Weis Prediction Model are useful screening tools for GCA with the potential to improve the effective use of health care resources” the presenters report.