Comparison of classification criteria for giant cell arteritis

Filatova E.: Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University, Moscow, Russia

Bulanov N.: Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University, Moscow, Russia

Borodin O.O.: Tareev Clinic of Internal Diseases, Sechenov University

Meshkov A.D.: Laboratory of Musculoskeletal Diseases, Russian Scientific Clinical Center for Gerontology, Pirogov Russian Research Medical University

Smitienko I.O.: Medical Center К+31

Chachilo E.: Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University

Nartov A.: Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University

Suvorov A.: Center for Analysis of Complex Systems, Sechenov First Moscow State Medical University, Moscow

Filatova A.: Lomonosov Moscow State University

Naumov A.V.: 3 Laboratory of Musculoskeletal Diseases, Russian Scientific Clinical Center for Gerontology, Pirogov Russian Research Medical University

Iwanitsky L.V.: Vladimirsky Moscow Regional Research and Clinical Institute

Novikov P.: Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University, Moscow, Russia

Moiseev S.: Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University, Moscow, Russia

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Summary

Aim

To compare the diagnostic value of classification criteria for giant cell arteritis (GCA).

Material and methods

In a retrospective study, we evaluted the 1990 American College of Rheumatology (ACR) criteria, 2016 revised ACR criteria and 2022 ACR and European Alliance of Associations for Rheumatology (EULAR) criteria for GCA. Their diagnostic value was determined using the binary classification quality assessment methods.

Results

Eighty four GCA patients (63 females, median age 67 years) with or without polymyalgia rheumatica (PMR) comprised the study group, whereas 46 patients with PMR (39 females, median age 66 years) were enrolled in the control group. The 2016 revised ACR and 2022 ACR/EULAR criteria had higher sensitivity (71.4% and 71.4%, respectively) than the 1990 ACR criteria. Compared with other criteria, the 2022 ACR/EULAR criteria had better specificity (97.8%), predicted values of positive result (98.4%) and negative result (65.2%), likelihood ratio of positive test result (32.9) and negative result (0.3), Youden's J index (0.695), AUC (0.846) and Acc (80.8%). The 2022 ACR/EULAR criteria were informative for both cranial and constitutional phenotypes of GCA.

Conclusion

The 2022 ACR/EULAR classification criteria for GCA have a higher value in established large vessel vasculitis compared to the 1990 ACR and 2016 ACR criteria.

Key words

Giant cell arteritis, polymyalgia rheumatica, phenotypes, classification criteria.