First profiling of the national Swiss Clinical Quality Management giant cell arteritis and polymyalgia rheumatica...

To describe patient characteristics, comorbidities, diagnostic approaches, and treatment patterns in the Swiss giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) registry.

In 2020, a national GCA and PMR cohort was established within the Swiss Clinical Quality Management (SCQM) in rheumatic diseases registry.

Between August 2020 and June 2024, 436 patients were included (337 GCA, 99 PMR). Median age was 72 years (IQR 65-77) in GCA and 71 years (IQR 63-77) in PMR; 64% and 56% were female, respectively. At diagnosis, 81% of GCA patients reported cranial symptoms, 31% visual symptoms, and 43% polymyalgic symptoms. In PMR, 95% reported shoulder girdle pain, 85% pelvic girdle pain, and 44% neck pain. Ultrasound was the most used diagnostic modality in GCA (76%), followed by PET-CT (59%) and MRI (40%). Temporal artery biopsy was performed in 29% of GCA patients, with a positivity rate of 66%. Glucocorticoids were still used by 79%, 50%, and 37% of GCA patients at 6, 12, and 24 months, respectively. Steroid-sparing agents were prescribed in 77% of patients, most commonly tocilizumab (73%). Common comorbidities included hypertension (51% GCA, 44% PMR), diabetes (15% GCA, 12% PMR), and osteoporosis (26% GCA, 15% PMR).

The SCQM registry provides real-world data on the management of GCA-PMR spectrum disease (GPSD) patients. Imaging has largely replaced histology for GCA diagnosis. Despite 75% of GCA patients receiving tocilizumab, one-third remained on glucocorticoids beyond 2 years. Such registries are expected to optimise care for this often fragile GPSD population.