Optimizing the use of temporal artery biopsy: a retrospective study

Area of Science:

• Rheumatology
• Vascular Medicine
• Diagnostic Pathology

Background:

• Giant cell arteritis (GCA) is the most common primary vasculitis affecting large and medium-sized vessels.
• Diagnosis relies on clinical criteria, often supplemented by temporal artery biopsy (TAB).
• Optimal patient selection and expected TAB positivity rates remain debated.

Purpose of the Study:

• To determine the positivity rate of temporal artery biopsies in suspected GCA cases.
• To investigate associations between TAB positivity and clinical factors.
• To evaluate the utility of TAB in high-suspicion GCA patients.

Main Methods:

• A retrospective cross-sectional study analyzed 127 patients with suspected GCA undergoing TAB.
• Data collected included clinical suspicion, symptoms (e.g., jaw claudication), biopsy delay, length, and corticosteroid use.
• Primary outcome was TAB positivity rate; secondary outcomes explored associations with clinical variables.

Main Results:

• The overall TAB positivity rate was 23.7%.
• Jaw claudication and high initial clinical suspicion were significantly associated with positive biopsies.
• High clinical suspicion also correlated with continued corticosteroid treatment post-biopsy, irrespective of results.

Conclusions:

• Temporal artery biopsy positivity rate in suspected GCA is 23.7%.
• High clinical suspicion for GCA may be a sufficient criterion for treatment, potentially obviating the need for TAB.
• TAB may not be essential for all patients with suspected GCA, especially when clinical suspicion is high.