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ORIGINAL RESEARCH article

Front. Med.
Sec. Rheumatology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1436707
This article is part of the Research Topic Updates on Giant Cell Arteritis: Pathogenesis, Diagnosis and Treatment- Volume II View all 9 articles

Vascular ultrasound as a follow-up tool in patients with giant cell arteritis: A prospective observational cohort study

Provisionally accepted
Anne C Bull Haaversen Anne C Bull Haaversen 1,2*Lene Kristin Brekke Lene Kristin Brekke 3Tanaz Kermani Tanaz Kermani 4Øyvind Molberg Øyvind Molberg 1,5Andreas P Diamantopoulos Andreas P Diamantopoulos 6
  • 1 University of Oslo, Oslo, Oslo, Norway
  • 2 Martina Hansens Hospital, Sandvika, Norway
  • 3 Department of Rheumatology, Haugesund Hospital for Rheumatic Diseases, Haugesund, Norway
  • 4 Department of Rheumatology, University of California, Los Angeles, United States
  • 5 Department of Rheumatology, Rikshospitalet, Oslo, Norway
  • 6 Division of Internal Medicine, Department of Infectious Diseases, Akershus University Hospital, Lørenskog, Norway

The final, formatted version of the article will be published soon.

    To evaluate relapses in giant cell arteritis (GCA), investigate the utility of vascular ultrasound to detect relapses, and develop and assess a composite score for GCA disease activity (GCAS) based on clinical symptoms, ultrasound imaging activity, and C-reactive protein (CRP).Patients with GCA were prospectively followed with scheduled visits, including assessment for clinical relapse, protocol ultrasound examination, and CRP. At each visit, patients were defined as having ultrasound remission or relapse. GCAS was calculated at every visit.The study included 132 patients, with a median follow-up time of 25 months (interquartile range (IR) 21). The clinical relapse rate was 60.6%. There were no differences in relapse rates between GCA subtypes (cranial-GCA, large vessel (LV)-GCA, and mixed-GCA) (p = 0.83).Ultrasound yielded a sensitivity of 61.2% and a specificity of 72.3% for diagnosing GCArelapse in our cohort. In 7.7% of follow-up visits with clinical relapses, neither high CRP nor findings of ultrasound relapse were registered. In comparison, in 29.4% of follow-up visits, there was both a high CRP and findings of ultrasound relapse but no symptoms of clinical relapse.We found moderate sensitivity and specificity for ultrasound as a monitoring tool for relapse in this prospective cohort of GCA patients. The extent or subtype of vasculitis at the diagnosis did not influence the number of relapses. Based on a combination of clinical symptoms, elevated CRP, and ultrasound findings, a composite score for GCA activity is proposed.

    Keywords: Giant Cell Arteritis, ultrasound, relapse, follow-up, Large vessel vasculitis

    Received: 22 May 2024; Accepted: 15 Jul 2024.

    Copyright: © 2024 Haaversen, Brekke, Kermani, Molberg and Diamantopoulos. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Anne C Bull Haaversen, University of Oslo, Oslo, 0316, Oslo, Norway

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