Performance of the modified 2022 ACR/EULAR giant cell arteritis classification criteria without age restriction for discriminating from Takayasu arteritis
Abstract Objective To evaluate the ability to discriminate giant cell arteritis (GCA) from Takayasu arteritis (TAK) according to the modified 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) GCA classification criteria. Methods Patients enrolled in...
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2025-01-01
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| Series: | Arthritis Research & Therapy |
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| Online Access: | https://doi.org/10.1186/s13075-025-03486-y |
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| author | Takahiko Sugihara Masayoshi Harigai Haruhito A. Uchida Hajime Yoshifuji Yasuhiro Maejima Jun Ishizaki Yoshiko Watanabe Hiroaki Dobashi Yoshinori Komagata Naoto Tamura Yoshikazu Nakaoka Japan Research Committee of the Ministry of Health, Labour, and Welfare for Intractable Vasculitis (JPVAS) |
| author_facet | Takahiko Sugihara Masayoshi Harigai Haruhito A. Uchida Hajime Yoshifuji Yasuhiro Maejima Jun Ishizaki Yoshiko Watanabe Hiroaki Dobashi Yoshinori Komagata Naoto Tamura Yoshikazu Nakaoka Japan Research Committee of the Ministry of Health, Labour, and Welfare for Intractable Vasculitis (JPVAS) |
| author_sort | Takahiko Sugihara |
| collection | DOAJ |
| description | Abstract Objective To evaluate the ability to discriminate giant cell arteritis (GCA) from Takayasu arteritis (TAK) according to the modified 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) GCA classification criteria. Methods Patients enrolled in the Japanese nationwide retrospective registry were evaluated using the criteria with partial modification; wall thickening of descending thoracic-abdominal aorta were mainly diagnosed by contrast-enhanced computed tomography (CT) or magnetic resonance imaging instead of evaluating with positron emission tomography (PET)-CT. The discriminability of the criteria was evaluated using C-statistic (> 0.7: good ability). Results Newly diagnosed patients with GCA (n = 139) and TAK (n = 129) were assessed, and 23.3% of TAK were aged 50 years or older at onset. The sensitivity of the modified 2022 ACR/EULAR GCA classification criteria with a score ≥ 6 was 82.0%, 68.5%, and 32.1% in all GCA, GCA with large-vessel involvement, and GCA without cranial arteritis, respectively. The specificity of the modified criteria was 96.1% for the 129 TAK as controls. Five patients with late-onset TAK met the modified criteria, and four had cranial signs and symptoms, two had bilateral axillary artery involvement, and four had descending thoracic-abdominal aorta involvement. The discriminability of the criteria was good (C-statistic: 0.986, 95% confidence interval [CI]: 0.976–0.996) and remained good after excluding age (C-statistic: 0.927, 95% CI: 0.894–0.961). The discriminability of a set of large-vessel lesions (bilateral axillary artery and descending thoracic-abdominal aorta) and inflammatory markers was markedly decreased with poor C-statistic value (C-statistic: 0.598, 95% CI: 0.530–0.667). Discriminability was improved after adding polymyalgia rheumatica (PMR) (C-statistic: 0.757, 95% CI: 0.700–0.813) or age (C-statistic: 0.913, 95%CI: 0.874–0.951) to the set of large-vessel lesions. In GCA patients with a score ≤ 5, 52% had bilateral subclavian and/or axillary artery involvement. Conclusion The modified 2022 ACR/EULAR GCA classification criteria well performed in classifying GCA and TAK without PET-CT in routine clinical practice. A set of items included in the modified GCA classification criteria had good discriminative ability for GCA and TAK, even when age was excluded. However, age restriction or PMR was required to distinguish GCA without cranial lesions from TAK. |
| format | Article |
| id | doaj-art-3097ef65ad7742b7858582c1f3474b1a |
| institution | Kabale University |
| issn | 1478-6362 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | Arthritis Research & Therapy |
| spelling | doaj-art-3097ef65ad7742b7858582c1f3474b1a2025-02-02T12:35:39ZengBMCArthritis Research & Therapy1478-63622025-01-0127111210.1186/s13075-025-03486-yPerformance of the modified 2022 ACR/EULAR giant cell arteritis classification criteria without age restriction for discriminating from Takayasu arteritisTakahiko Sugihara0Masayoshi Harigai1Haruhito A. Uchida2Hajime Yoshifuji3Yasuhiro Maejima4Jun Ishizaki5Yoshiko Watanabe6Hiroaki Dobashi7Yoshinori Komagata8Naoto Tamura9Yoshikazu Nakaoka10Japan Research Committee of the Ministry of Health, Labour, and Welfare for Intractable Vasculitis (JPVAS)Department of Rheumatology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDivision of Rheumatology, Department of Internal Medicine, Tokyo Women’s Medical University School of MedicineDepartment of Chronic Kidney Disease and Cardiovascular Disease, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineDepartment of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto UniversityDepartment of Cardiovascular Medicine, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDepartment of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of MedicineDepartment of General Medicine, Kawasaki Medical SchoolDivision of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa UniversityDepartment of Nephrology and Rheumatology, Kyorin University School of MedicineDepartment of Internal Medicine and Rheumatology, Juntendo University School of MedicineDepartment of Vascular Physiology, National Cerebral and Cardiovascular Center Research InstituteAbstract Objective To evaluate the ability to discriminate giant cell arteritis (GCA) from Takayasu arteritis (TAK) according to the modified 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) GCA classification criteria. Methods Patients enrolled in the Japanese nationwide retrospective registry were evaluated using the criteria with partial modification; wall thickening of descending thoracic-abdominal aorta were mainly diagnosed by contrast-enhanced computed tomography (CT) or magnetic resonance imaging instead of evaluating with positron emission tomography (PET)-CT. The discriminability of the criteria was evaluated using C-statistic (> 0.7: good ability). Results Newly diagnosed patients with GCA (n = 139) and TAK (n = 129) were assessed, and 23.3% of TAK were aged 50 years or older at onset. The sensitivity of the modified 2022 ACR/EULAR GCA classification criteria with a score ≥ 6 was 82.0%, 68.5%, and 32.1% in all GCA, GCA with large-vessel involvement, and GCA without cranial arteritis, respectively. The specificity of the modified criteria was 96.1% for the 129 TAK as controls. Five patients with late-onset TAK met the modified criteria, and four had cranial signs and symptoms, two had bilateral axillary artery involvement, and four had descending thoracic-abdominal aorta involvement. The discriminability of the criteria was good (C-statistic: 0.986, 95% confidence interval [CI]: 0.976–0.996) and remained good after excluding age (C-statistic: 0.927, 95% CI: 0.894–0.961). The discriminability of a set of large-vessel lesions (bilateral axillary artery and descending thoracic-abdominal aorta) and inflammatory markers was markedly decreased with poor C-statistic value (C-statistic: 0.598, 95% CI: 0.530–0.667). Discriminability was improved after adding polymyalgia rheumatica (PMR) (C-statistic: 0.757, 95% CI: 0.700–0.813) or age (C-statistic: 0.913, 95%CI: 0.874–0.951) to the set of large-vessel lesions. In GCA patients with a score ≤ 5, 52% had bilateral subclavian and/or axillary artery involvement. Conclusion The modified 2022 ACR/EULAR GCA classification criteria well performed in classifying GCA and TAK without PET-CT in routine clinical practice. A set of items included in the modified GCA classification criteria had good discriminative ability for GCA and TAK, even when age was excluded. However, age restriction or PMR was required to distinguish GCA without cranial lesions from TAK.https://doi.org/10.1186/s13075-025-03486-yGCATAKClassification criteriaBilateral axillary arteryDescending thoracic-abdominal aortaBilateral subclavian artery |
| spellingShingle | Takahiko Sugihara Masayoshi Harigai Haruhito A. Uchida Hajime Yoshifuji Yasuhiro Maejima Jun Ishizaki Yoshiko Watanabe Hiroaki Dobashi Yoshinori Komagata Naoto Tamura Yoshikazu Nakaoka Japan Research Committee of the Ministry of Health, Labour, and Welfare for Intractable Vasculitis (JPVAS) Performance of the modified 2022 ACR/EULAR giant cell arteritis classification criteria without age restriction for discriminating from Takayasu arteritis Arthritis Research & Therapy GCA TAK Classification criteria Bilateral axillary artery Descending thoracic-abdominal aorta Bilateral subclavian artery |
| title | Performance of the modified 2022 ACR/EULAR giant cell arteritis classification criteria without age restriction for discriminating from Takayasu arteritis |
| title_full | Performance of the modified 2022 ACR/EULAR giant cell arteritis classification criteria without age restriction for discriminating from Takayasu arteritis |
| title_fullStr | Performance of the modified 2022 ACR/EULAR giant cell arteritis classification criteria without age restriction for discriminating from Takayasu arteritis |
| title_full_unstemmed | Performance of the modified 2022 ACR/EULAR giant cell arteritis classification criteria without age restriction for discriminating from Takayasu arteritis |
| title_short | Performance of the modified 2022 ACR/EULAR giant cell arteritis classification criteria without age restriction for discriminating from Takayasu arteritis |
| title_sort | performance of the modified 2022 acr eular giant cell arteritis classification criteria without age restriction for discriminating from takayasu arteritis |
| topic | GCA TAK Classification criteria Bilateral axillary artery Descending thoracic-abdominal aorta Bilateral subclavian artery |
| url | https://doi.org/10.1186/s13075-025-03486-y |
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