Author:
Iudici Michele,Hemmig Andrea Katharina,Stegert Mihaela,Courvoisier Courvoisier,Adler Sabine,Becker Mike Oliver,Berger Christoph T.,Dan Diana,Finckh Axel,Mahr Alfred,Neumann Thomas,Reichenbach Stephan,Ribi Camillo,Seitz Luca,Villiger Peter,Wildi Lukas,Daikeler Thomas,On behalf of Giant Cell Arteritis SCQM Study Group
Abstract
AIMS OF THE STUDY: To assess current practices in diagnosing, treating, and following-up giant-cell arteritis by specialists in Switzerland and to identify the main barriers to using diagnostic tools.
METHODS: We performed a national survey of specialists potentially caring for patients with giant-cell arteritis. The survey was sent by email to all members of the Swiss Societies of Rheumatology and for Allergy and Immunology. A reminder was sent to nonresponders after 4 and 12 weeks. Its questions covered the following dimensions: respondents’ main characteristics, diagnosis, treatment, and imaging’s role during follow-up. The main study results were summarized using descriptive statistics.
RESULTS: Ninety-one specialists, primarily aged 46–65 years (n = 53/89; 59%), working in academic or nonacademic hospitals or private practice, and treating a median of 7.5 (interquartile range [IQR]: 3–12) patients with giant-cell arteritis per year participated in this survey. Ultrasound of temporal arteries/large vessels (n = 75/90; 83%) and positron-emission-tomography-computed tomography (n = 52/91; 57%) or magnetic resonance imaging (n = 46/90; 51%) of the aorta/extracranial arteries were the most common techniques used to diagnose giant-cell arteritis with cranial or large vessel involvement, respectively. Most participants reported a short time to obtain imaging tests or arterial biopsy. The glucocorticoid tapering scheme, glucocorticoid-sparing agent, and glucocorticoid-sparing treatment duration varied among the participants. Most physicians did not follow a predefined repeat imaging scheme for follow-up and mainly relied on structural changes (vascular thickening, stenosis, or dilatation) to drive treatment choice.
CONCLUSIONS: This survey indicates that imaging and temporal biopsy are rapidly accessible for diagnosing giant-cell arteritis in Switzerland but highlights heterogeneous practice in many disease management areas.
Publisher
SMW Supporting Association