Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Jun 19;43(1):18-25.
doi: 10.1080/01658107.2018.1474372. eCollection 2019 Feb.

Systematic Review of the Yield of Temporal Artery Biopsy for Suspected Giant Cell Arteritis

Edsel B Ing  1 , Dan Ni Wang  2 , Abirami Kirubarajan  3 , Etienne Benard-Seguin  4 , Jingyi Ma  5 , James P Farmer  6   7 , Michel J Belliveau  6 , Galina Sholohov  8 , Nurhan Torun  9
Affiliations
Review

Systematic Review of the Yield of Temporal Artery Biopsy for Suspected Giant Cell Arteritis

Edsel B Ing et al. Neuroophthalmology. .

Abstract

Purpose: To determine the positive yield (utility rate) of temporal artery biopsy (TAB) in patients with suspected giant cell arteritis (GCA).

Study design: Systematic review (CRD42017078508) and meta-regression.

Materials and methods: All articles concerning TAB for suspected GCA with English language abstracts from 1998 to 2017 were retrieved. Articles were excluded if they exclusively reported positive TAB, or only cases of known GCA. Where available, the pre-specified predictors of age, sex, vision symptoms, jaw claudication, duration of steroid treatment prior to TAB, specimen length, bilateral TAB, and use of ultrasound/MRI (imaging) were recorded for meta-regression.

Results: One hundred and thirteen articles met eligibility criteria. The I 2 was 92%, and with such high heterogeneity, meta-analysis is unsuitable. The median yield of TAB was 0.25 (95% confidence interval 0.21 to 0.27), with interquartile range 0.17 to 0.34. On univariate meta-regression age (coefficient 0.012, p = 0.025) was the only statistically significant patient factor associated with TAB yield.

Conclusions: Systematic review revealed high heterogeneity in the yield of TAB. The median utility rate of 25% and its interquartile range provides a benchmark for decisions regarding the under/overutilization of TAB and aids in the evaluation of non-invasive alternatives for the investigation of GCA.

Keywords: Giant cell arteritis; meta-regression; systematic review; temporal artery biopsy; yield.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Risk of bias summary.
Figure 2.
Figure 2.
PRISMA flow diagram.
Figure 3.
Figure 3.
Histogram of the yield of temporal artery biopsy from 113 studies.
Figure 4.
Figure 4.
Random-effects meta-regression of age versus the yield of temporal artery biopsy.
See this image and copyright information in PMC

References

    1. Hunder G. The use and misuse of classification and diagnostic criteria for complex disease. Ann Intern Med. 1998;129(5):417–418. doi:10.7326/0003-4819-129-5-199809010-00013. - DOI - PubMed
    1. Murchison AP, Gilbert ME, Bilyk JR, et al. Validity of the American college of rheumatology criteria for the diagnosis of giant cell arteritis. Am J Ophthalmol. 2012. October;154(4):722–729. doi:10.1016/j.ajo.2012.03.045. - DOI - PubMed
    1. Weyand CM, Goronzy JJ. Giant-cell arteritis and polymyalgia rheumatica. N Engl J Med. 2014;371:50–57. doi:10.1056/NEJMcp1214825. - DOI - PMC - PubMed
    1. Dasgupta B, Borg FA, Hassan N, et al. BSR and BHPR guidelines for the management of giant cell arteritis. Rheumatology (Oxford). 2010. August;49(8):1594–1597. doi:10.1093/rheumatology/keq039a. - DOI - PubMed
    1. Albertini JG, Ramsey ML, Marks VJ. Temporal artery biopsy in a dermatologic surgery practice. Dermatol Surg. 1999. June;25(6):501–508. doi:10.1046/j.1524-4725.1999.08296.x. - DOI - PubMed