ACR/EULAR 2022 Classification Criteria Compared to the ACR 1990 Classification Criteria in the ARTESER Registry of Giant Cell Arteritis

Eugenio De Miguel¹, Iñigo Hernández-Rodríguez², Maite Silva-Diaz³, Joaquin María Belzunegui:⁴, Patricia Moya⁵, Marina Tortosa-Cabañas⁶, Vanessa Andrea Navarro⁷, Joan Calvet⁸, Ivette Casafont-Solé⁹, Jose A Román-Ivorra¹⁰, Selene Labrada-Arrabal¹¹, Margarida Vasques Rocha:¹², Carlota L Iñiguez:¹³, Vanesa Hernández-Hernández¹⁴, Cristina Campos-Fernández¹⁵, María Alcalde Villar:¹⁶, Antonio Juan-Mas¹⁷, Francisco-Javier Prado-Galbarro¹⁸, Itziar Calvo¹⁹, Julio Sánchez-Martín²⁰, Javier Narvaez-García²¹ and Ricardo Blanco-Alonso²², and ARTESER Project Collaborative Group, ¹Hospital Universitario La Paz, Madrid, Spain, ²Complejo Hospitalario Universitario de Vigo, Vigo, Spain, ³Complejo Hospitalario Universitario A Coruña, A Coruña, Spain, ⁴H de Donostia, Donostia-San Sebasti, Spain, ⁵Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, ⁶Hospital Universitario Ramón y Cajal, Madrid, Spain, ⁷Hospital Moisès Broggi, Sant Joan Despí, Spain, ⁸Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA) (UAB), 08208 Sabadell, Spain, Barcelona, Spain, ⁹Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain, Barcelona, Spain, ¹⁰Hospital Universitari i Politècnic la Fe, Valencia, Comunidad Valenciana, Spain, ¹¹Hospital del Mar, Barcelona, Spain, ¹²Hospital Universitario Araba, Vitoria, Spain, ¹³Hospital Universitario Lucus Augusti, Galicia, Spain, Galicia, Spain, ¹⁴Hospital Universitario de Canarias, San Cristobal de La Laguna, Canarias, Spain, ¹⁵Consorci Hospital General Universitari de València, Comunitat Valenciana, Spain, Valencia, Spain, ¹⁶Hospital Universitario Severo Ochoa Leganés, Madrid, Spain, Madrid, Spain, ¹⁷Rheumatology Department, Hospital Universitario Severo Ochoa Leganés, Madrid, Spain, Madrid, Cantabria, Spain, ¹⁸Departamento de Sistemas Biológicos, Universidad Autónoma Metropolitana-Unidad Xochimilco,, Mexico, Mexico, ¹⁹Hospital Universitario de Basurto, Bilbao, Spain, ²⁰Hospital Universitario 12 de Octubre, Madrid, Spain, ²¹Hospital Universitario de Bellvitge, Barcelona, Spain, ²²Division of Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Immunopathology group, Santander, Spain

Meeting: ACR Convergence 2024

Keywords: classification criteria, Epidemiology, giant cell arteritis, Vasculitis

Session Information

Date: Sunday, November 17, 2024

Title: Vasculitis – Non-ANCA-Associated & Related Disorders Poster II

Session Type: Poster Session B

Session Time: 10:30AM-12:30PM

Background/Purpose: The diagnosis of giant cell arteritis (GCA) has been guided for years by the ACR 1990 classification criteria but the emergence of the image has changed the diagnosis of the disease and has motivated the appearance of the new ACR/EULAR 2022 criteria the new ACR/EULAR 2022 criteria. The main objective of this analysis was to compare de performance of the new ACR/EULAR criteria in a big cohort of patients with the diagnosis of GCA before the publication and its comparation with the previous ACR 1990 criteria.

Methods: ARTESER is a multicenter observational longitudinal Registry, based on a review of the electronic health records of all patients diagnosed with GCA between June 1st, 2013 and March 29th, 2019. Was conducted in 26 hospitals of the Spanish National Health Service with the support of the Spanish Society of Rheumatology. Consecutive patients fulfilling confirmed diagnosis of GCA, age ≥50 years, and at least one of the following: (a) positive results in an objective diagnostic test such as a temporal artery biopsy and/or imaging technique, including ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT), vascular ultrasound or computed tomography angiography/magnetic resonance imaging (MRI) angiography; (b) meeting 3 of the 5 criteria of the 1990 ACR classification criteria; or c) the clinical opinion of the investigator (expert criteria). Data of the patients were described as n and % for qualitative variables and mean and SD for quantitative variables. For the comparison between the criteria, a bivariate analysis was carried out.

Results: Of the 1607 patients included in ARTESER, 73 were excluded due to the absence of the minimum data necessary to evaluate compliance with the criteria. Of the remaining 1535 patients, 1487 met ACR/EULAR 2022 criteria (96.9%) and 1348 met ACR 1990 criteria (87.8%). Most of the patients (1301) met both classification criteria, while 186 met only ACR/EULAR 2022 and 47 met only ACR 1990. Among a sub-analyses carried out, we compared the patients who met the criteria with only clinical and laboratory tests (385 patients) versus those who also had complementary imaging or biopsy diagnostic tests (1149 Patients; Table 1). We did not find clinically relevant differences, with the exception of headache, more prevalent in patients with only clinical and laboratory test. When we compare patients who exclusively meet the ACR 2022 criteria with the rest of the patients, we find that cranial clinical manifestations are less frequent and extracranial diagnostic tests are more frequent (Table 2)

Conclusion: The new ACR/EULAR 2022 criteria captured more patients than the ACR 1990 criteria. The fact that patient inclusion ended before the publication of the 2022 criteria emphasizes the greater classification power of the ACR/EULAR criteria. The new ACR/EULAR classification criteria showed greater sensitivity to detect large vessel involvement than the previous ones.

Table 1. Clinical manifestations and laboratory tests in patients with and without imaging or biopsy diagnostic tests meeting classification criteria

Table 2. Differences between patients meeting ACR/EULAR 2022 criteria only and patients meeting both ACR 1990 and ACR/EULAR 2022classification criteria

Disclosures: E. De Miguel: AbbVie/Abbott, 5, 6, BMS, 5, 6, Eli Lilly, 5, 6, Grunental, 5, 6, Janssen, 5, 6, Merck/MSD, 5, 6, Novartis, 5, 6, Pfizer, 5, 6, Roche, 5, 6, sanofi, 5, 6, UCB, 5, 6; I. Hernández-Rodríguez: None; M. Silva-Diaz: None; J. María Belzunegui:: None; P. Moya: None; M. Tortosa-Cabañas: None; V. Navarro: None; J. Calvet: None; I. Casafont-Solé: None; J. Román-Ivorra: None; S. Labrada-Arrabal: None; M. Vasques Rocha:: None; C. L Iñiguez:: None; V. Hernández-Hernández: None; C. Campos-Fernández: None; M. Alcalde Villar:: None; A. Juan-Mas: None; F. Prado-Galbarro: None; I. Calvo: None; J. Sánchez-Martín: None; J. Narvaez-García: None; R. Blanco-Alonso: AbbVie, 2, 5, 6, Bristol-Myers Squibb, 2, 6, Galapagos, 6, Janssen, 2, 6, Lilly, 2, 6, MSD, 2, 5, 6, Pfizer, 2, 6, Roche, 2, 5, 6.

To cite this abstract in AMA style:

De Miguel E, Hernández-Rodríguez I, Silva-Diaz M, María Belzunegui: J, Moya P, Tortosa-Cabañas M, Navarro V, Calvet J, Casafont-Solé I, Román-Ivorra J, Labrada-Arrabal S, Vasques Rocha: M, L Iñiguez: C, Hernández-Hernández V, Campos-Fernández C, Alcalde Villar: M, Juan-Mas A, Prado-Galbarro F, Calvo I, Sánchez-Martín J, Narvaez-García J, Blanco-Alonso R. ACR/EULAR 2022 Classification Criteria Compared to the ACR 1990 Classification Criteria in the ARTESER Registry of Giant Cell Arteritis [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/acr-eular-2022-classification-criteria-compared-to-the-acr-1990-classification-criteria-in-the-arteser-registry-of-giant-cell-arteritis/. Accessed .

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