Giant Cell Arteritis Baseline Characteristics Do Not Have A Racial Component

Patients of Black and White backgrounds can have similar baseline characteristics pointing to giant cell arteritis.

Giant cell arteritis baseline characteristics are similar for patients of White and Black ethnicities, according to research published in Journal of Neuro Ophthalmology. The findings suggest physicians may rely on the clinical features for the diagnosis of giant cell arteritis independent of race.

Until recently, researchers believed that low giant cell arteritis case numbers among patients who are Black suggested low incidence. But a more recent study suggests giant cell arteritis rates between individuals who are Black and White are close. “In order to reduce racial disparities in health care, it is necessary to confront our preconceived assumptions and biases surrounding disease,” according to the researchers. “There is little information on [giant cell arteritis] in black patients to provide adequate guidance when it comes to considering and diagnosing this disease.”

Investigators conducted a retrospective cohort study to examine biopsy-proven giant cell arteritis baseline presentation. The team compared presenting symptoms, laboratory findings, and giant cell arteritis calculator risk score in participants who self-identified as Black and those who self-identified as White.

[Giant cell arteritis] is not a disease that affects only White populations as previously assumed.

Of 85 patients with biopsy-proven giant cell arteritis (mean age, 76 years; range, 53–94; 72% women and 28% men), 84% were White and 14% were Black. 

The study shows higher rates of elevated platelet count in patients who were White than Black (34% vs 0%; P =.04) and higher rates of diabetes mellitus in patients who were Black than White (67% vs 12%; P <.001). 

The team found no statistically significant differences in any giant cell arteritis baseline or demographic characteristics (including age, gender, biopsy classification, cranial symptoms, visual symptoms, ophthalmic findings, rates of abnormal erythrocyte sedimentation rate, C-reactive protein, unintentional weight loss, polymyalgia rheumatica, or giant cell arteritis risk calculator score).

“[Giant cell arteritis] is not a disease that affects only White populations as previously assumed. Our findings serve as an important reminder to physicians that GCA presents similarly in Black and White patients,” according to the researchers.. 

Limitations of the study included the single-center, retrospective design, unavailability of baseline symptoms for some patients, and lack of assessment of corticosteroid use.

References:

Sun E, Li X, Gruener AM, Chang JR, Henderson AD, Carey AR. Baseline characteristics and clinical presentation of biopsy-proven giant cell arteritis in White compared with Black patients. J Neuroophthalmol. Published online March 2, 2023. doi:10.1097/WNO.0000000000001817