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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
06:35

An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis

Published on: February 8, 2019

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Can rheumatologists diagnose and manage Giant Cell Arteritis better than non-rheumatologists? The Maltese Experience

Erika Cefai1, Marica Galea1, Rebecca Galea1

  • 1Department of Rheumatology, Mater Dei Hospital, Msida, Malta.

Mediterranean Journal of Rheumatology
|March 19, 2020
PubMed

Insights

Giant Cell Arteritis (GCA) has a low incidence in Malta. While rheumatologists better adhere to guidelines for GCA management, overall improvement is needed for optimal patient outcomes.

Area of Science:

  • Rheumatology
  • Epidemiology
  • Internal Medicine

Background:

  • Giant Cell Arteritis (GCA) presents diagnostic and management challenges due to its varied presentation across medical specialties.
  • Effective management and diagnosis are crucial for preventing complications associated with GCA.

Purpose of the Study:

  • To determine the incidence of biopsy-proven GCA in Malta.
  • To compare the management strategies for GCA between rheumatologists and non-rheumatologists.

Main Methods:

  • A retrospective observational population study analyzed data from patients undergoing temporal artery biopsy (TAB) between 2012 and 2015.
  • Data included demographics, symptoms, TAB histology, treatment, and outcomes, benchmarked against British Society for Rheumatology (BSR) 2010 guidelines.

Main Results:

  • The incidence of biopsy-proven GCA in Malta (over 50 population) was 3.82 per 100,000 patient-years.
  • Rheumatologist involvement was associated with a higher likelihood of positive TAB results (30.5% vs. 14.1%) and more adherence to high-dose corticosteroid treatment and regular monitoring.
  • Only 43.3% of confirmed GCA cases received rheumatology input.

Conclusions:

  • Malta exhibits a low incidence of biopsy-proven GCA.
  • While rheumatologists demonstrate better adherence to GCA management guidelines, there is a need for broader improvement in care standardization.
  • Rheumatologists should lead efforts to minimize management variations and optimize GCA patient care.
Abstract

Keywords:
Giant cell arteritisdiagnosisincidencerheumatologists

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