ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 2773

Diagnostic and Therapeutic Management of a Suspected Case of GCA: An Opinion Survey

Henri Guillet1, Raphaël Porcher2, Alain Saraux3, Loïc Guillevin4, Luc Mouthon4 and Alexis Régent4, 1Département d'aval des urgences, CHU Henri Mondor, Créteil, France, 2Université Paris Descartes Sorbonne Paris, Paris, France, 3Rheumatology, CHU Brest, Brest, France, 4Institut Cochin, INSERM U1016, CNRS UMR 8104, PARIS, France

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: corticosteroids, Doppler ultrasound, giant cell arteritis, primary care and temporal arteritis

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Date: Tuesday, October 23, 2018

Session Title: Vasculitis Poster III: Immunosuppressive Therapy in Giant Cell Arteritis and Polymyalgia Rheumatica

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Giant-cell arteritis (GCA) is the most common vasculitis. Specialists have formulated recommendations on how to manage a patient with a possible diagnosis of GCA. However, general practitioners’ (GPs) and internal medicine or rheumatology specialists’ practices may differ from those recommendations.

Methods: We conducted an opinion survey to determine how they would hypothetically diagnose and manage a suspected case of GCA in France, based on 2 very short “case-vignette” clinical case descriptions, each representing a situation more-or-less typical of GCA, followed by multiple- or single-choice questions. Questionnaires were emailed via the French doctors’ Medical Association, and French societies of internal medicine (SNFMI) and rheumatology (SFR).

Results: Between November 2016 and March 2018, 967 GPs and 485 specialists returned their completed questionnaires. Respectively, >46% and 96%, reported having had a confirmed GCA case in consultation. Hypothetical responses, expressed as the % of cases, are how these doctors think they would react to the described cases. Among GPs, 49.1% would systematically refer the patient to a specialist. GPs would initially diagnose 32.1% and prescribe glucocorticoids (GCs), for the most typical GCA case (P<0.05), without any visual complications (P<0.05). GPs with a prior suspected-GCA case would start GCs more often (P<0.05). GPs would start GCs for 40.6%, at 1 mg/kg/day for 66.4% of them, and set up a temporal artery biopsy (TAB), within a mean of 7–15 days for 78.8%, and imaging studies for 10.2%, mainly TA-color duplex ultrasonography (TA-CDU) for 77.5%. GPs would prescribe antiplatelet drugs for 17.8%. Internal medicine and rheumatology specialists would order a TAB for 80.6%, within a mean of 4–7 days, and imaging investigations for 16.2%, mainly TA-CDU (68.8%) or PET scan (43.9%). Among specialists starting GCs, the preferred dose would be 0.7 mg/kg/day for 46.9%. Specialists would prescribe antiplatelet drugs to 51.7%. Among GPs and specialists who would start GCs, TABs would be ordered for similar percentages of cases, but specialists did so earlier (P<0.05). GPs and specialists prescribed GCs based only on clinical findings for 14.1% and 8.7%, respectively. GPs would not order a TAB, considering it too complicated to set up, for 67%. Specialists used imaging more often to diagnose GCA (P<0.05). Finally, GPs would prescribe significantly higher GC doses (P<0.05).

Conclusion: Based on survey findings for 2 hypothetical cases, nearly a third of GCA cases would be managed by GPs alone. GPs and specialists would prefer TAB as the diagnostic test and TA-CDU as the imaging modality, and neither group would seek confirmation for 14.1% or 8.7%, respectively. Daily GC doses and antiplatelet-drug prescriptions would differ between GPs and specialists.


Disclosure: H. Guillet, None; R. Porcher, None; A. Saraux, None; L. Guillevin, None; L. Mouthon, None; A. Régent, None.

To cite this abstract in AMA style:

Guillet H, Porcher R, Saraux A, Guillevin L, Mouthon L, Régent A. Diagnostic and Therapeutic Management of a Suspected Case of GCA: An Opinion Survey [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/diagnostic-and-therapeutic-management-of-a-suspected-case-of-gca-an-opinion-survey/. Accessed March 3, 2021.
  • Tweet
  • Email
  • Print
Save to PDF

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/diagnostic-and-therapeutic-management-of-a-suspected-case-of-gca-an-opinion-survey/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.