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
. 2022 Dec;74(12):1881-1889.
doi: 10.1002/art.42325. Epub 2022 Nov 8.

2022 American College of Rheumatology/EULAR Classification Criteria for Giant Cell Arteritis

Cristina Ponte  1 , Peter C Grayson  2 , Joanna C Robson  3 , Ravi Suppiah  4 , Katherine Bates Gribbons  2 , Andrew Judge  5 , Anthea Craven  6 , Sara Khalid  6 , Andrew Hutchings  7 , Richard A Watts  8 , Peter A Merkel  9 , Raashid A Luqmani  6 ; DCVAS Study Group
Collaborators, Affiliations

2022 American College of Rheumatology/EULAR Classification Criteria for Giant Cell Arteritis

Cristina Ponte et al. Arthritis Rheumatol. 2022 Dec.

Abstract

Objective: To develop and validate updated classification criteria for giant cell arteritis (GCA).

Methods: Patients with vasculitis or comparator diseases were recruited into an international cohort. The study proceeded in 6 phases: 1) identification of candidate items, 2) prospective collection of candidate items present at the time of diagnosis, 3) expert panel review of cases, 4) data-driven reduction of candidate items, 5) derivation of a points-based risk classification score in a development data set, and 6) validation in an independent data set.

Results: The development data set consisted of 518 cases of GCA and 536 comparators. The validation data set consisted of 238 cases of GCA and 213 comparators. Age ≥50 years at diagnosis was an absolute requirement for classification. The final criteria items and weights were as follows: positive temporal artery biopsy or temporal artery halo sign on ultrasound (+5); erythrocyte sedimentation rate ≥50 mm/hour or C-reactive protein ≥10 mg/liter (+3); sudden visual loss (+3); morning stiffness in shoulders or neck, jaw or tongue claudication, new temporal headache, scalp tenderness, temporal artery abnormality on vascular examination, bilateral axillary involvement on imaging, and fluorodeoxyglucose-positron emission tomography activity throughout the aorta (+2 each). A patient could be classified as having GCA with a cumulative score of ≥6 points. When these criteria were tested in the validation data set, the model area under the curve was 0.91 (95% confidence interval [95% CI] 0.88-0.94) with a sensitivity of 87.0% (95% CI 82.0-91.0%) and specificity of 94.8% (95% CI 91.0-97.4%).

Conclusion: The 2022 American College of Rheumatology/EULAR GCA classification criteria are now validated for use in clinical research.

PubMed Disclaimer

Comment in

References

REFERENCES

    1. Watts RA, Robson J. Introduction, epidemiology and classification of vasculitis [review]. Best Pract Res Clin Rheumatol 2018;32:3-20.
    1. Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference nomenclature of vasculitides. Arthritis Rheum 2013;65:1-11.
    1. Ponte C, Águeda AF, Luqmani RA. Clinical features and structured clinical evaluation of vasculitis. Best Pract Res Clin Rheumatol 2018;32:31-51.
    1. Hunder GG, Bloch DA, Michel BA, et al. The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum 1990;33:1122-8.
    1. Dejaco C, Ramiro S, Duftner C, et al. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice. Ann. Rheum Dis 2018;77:636-43.

Publication types