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
. 2024 Dec;83(Suppl 3):285-288.
doi: 10.1007/s00393-024-01532-9. Epub 2024 Jun 4.

Recommendations for defining giant cell arteritis fast-track clinics. English version

Wolfgang A Schmidt  1 , Michael Czihal  2 , Michael Gernert  3 , Wolfgang Hartung  4 , Bernhard Hellmich  5 , Sarah Ohrndorf  6 , Gabriela Riemekasten  7 , Valentin S Schäfer  8 , Johannes Strunk  9 , Nils Venhoff  10
Affiliations

Recommendations for defining giant cell arteritis fast-track clinics. English version

Wolfgang A Schmidt et al. Z Rheumatol. 2024 Dec.

Abstract
in English, German

A German expert committee recommends defining fast-track clinics (FTC) for the acute diagnosis of giant cell arteritis (GCA) as follows: easy and prompt reachability at least on weekdays, scheduling appointments ideally within 24 h, examination by a specialist with GCA expertise, ≥ 2 experts per FTC, ≥ 50 patients with suspected GCA per year, sonologists with ≥ 300 (≥ 50) temporal and axillary artery examinations, adherence to standard operating procedures, availability of an ≥ 18 (≥ 15) MHz and a lower frequency linear ultrasound probe, and collaboration with partners for neurology and ophthalmology consultations, magnetic resonance imaging (MRI), positron emission tomography-computed tomography (PET-CT, possibly CT), and for temporal artery biopsy.

Eine Expertenkommission empfiehlt, Fast-Track Kliniken (FTK) für die Akutdiagnostik der Riesenzellarteriitis (RZA) folgendermaßen zu definieren: niederschwellige, mindestens werktägliche Erreichbarkeit, Terminvergabe idealerweise innerhalb von 24 h, Untersuchung durch Facharzt mit RZA-Expertise, ≥ 2 Experten pro FTK, ≥ 50 Patienten mit Verdacht auf RZA-Patienten pro Jahr, Ultraschalluntersucher mit ≥ 300 (≥ 50) Untersuchungen von Temporal- und Axillararterien, Befolgung von Standardisierungsanweisungen, Verfügbarkeit eines Schallkopfs ≥ 18 (≥ 15) MHz- und eines niederfrequenteren Linearultraschallkopfs und von Kooperationspartnern für zeitnahe Durchführung von augenärztlichen und neurologischen Untersuchungen, Magnetresonanztomographie (MRT), Positronenemissionstomographie-Computertomographie (PET-CT, ggf. CT) und Temporalarterienbiopsie.

Keywords: Computed tomography; Magnetic resonance imaging; Polymyalgia rheumatica; Positron emission tomography; Ultrasound.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflict of interest: The idea for drafting these recommendations originated in an expert panel initiated by Novartis Pharma GmbH, with 8 of 10 authors participating (all except VSS and WH). All subsequent activities for developing the recommendations were conducted independently of Novartis. W.A. Schmidt: Speaker for Abbvie, Amgen, Bristol Myers Squibb, Chugai, GlaxoSmithKline, Johnson & Johnson, Medac, Novartis, Roche, UCB; Consultant for Abbvie, Amgen, Fresenius Kabi, GlaxoSmithKline, Novartis, Sanofi; Research support as principal investigator from Abbvie, GlaxoSmithKline, Novartis, Sanofi; Member of recommendation initiatives of EULAR (Imaging in rheumatoide arthritis, Management of PMR (EULAR/ACR), conducting of ultrasound courses, ultrasound synovitis scoring, management of large vessel vasculitides, imaging in large vessel vasculitis 2018 and 2023, publication von research on ultrasound, imaging in crystal arthropathies); of the British Society for Rheumatology (diagnosis and management of GCA), of AWMF (management of large vessel vasculitis, management of gout) and the International GCA/PMR Study Group (recommendations for early referral of individuals with suspected PMR). M. Czihal: Speaker for Bayer, Bristol Myers Squibb, Lilly, Leo Pharma, MSD Sharp & Dohme, Novartis, Roche, UCB; Consultant for Novartis, Roche. M. Gernert: Speaker for Abbvie, Lilly, Janssen, Novartis; Consultant for Amgen, Astrazeneca, Novartis, Takeda; Congress sponsoring from Abbvie, Lilly, Hexal, Janssen, Pfizer, UCB. W. Hartung: Speaker for Abbvie, Amgen, Bristol Myers Squibb, Chugai, Novartis; Alpinion; Canon HealthCare; Board Member of DEGUM. B. Hellmich: Speaker for Abbvie, AstraZeneca, BMS, GSK, Janssen, Novartis, Orgentec, Pfizer, Roche, Vifor; Beraterhonorare für Abbvie, BMS, InflaRx, GSK, Novartis, Roche, Vifor; Member of recommendation initiatives: The author was convenor of the EULAR Recommendations 2018 and the AWMF guidelines on management of large vessel vasculitis. S. Ohrndorf: Speaker for AbbVie, Amgen, AstraZeneca, Bristol Myers Squibb (BMS), Galapagos (Alfasigma), Janssen, Mylan, Novartis, UCB; Consultant for Amgen, Janssen, Novartis; Research support as Principal Investigator for Novartis. G. Riemekasten: Consultant for Novartis. V. Schäfer: Speaker for AbbVie, Novartis, BMS, Chugai, Celgene, Medac, Sanofi, Lilly, Hexal, Pfizer, Janssen, Roche, Schire, Onkowissen, Royal College London, Boehringer-Ingelheim, UCB Fresenius, Alexion; Consultant for Novartis, Chugai, AbbVie, Celgene, Sanofi, Lilly, Hexal, Pfizer, Amgen, BMS, Roche, Gilead, Medac, Boehringer-Ingelheim, Alexion; Research support from Novartis, Hexal, Lilly, Roche, Celgene, Universität Bonn, Boehringer-Ingelheim, Butterfly IQ, MEDAC, Alexion, DGRh. J. Strunk: Speaker and Consultant for AbbVie, Amgen, Chugai, BMS, Boehringer, GSK, Galapagos, Janssen-Cilag, Medac, Novartis, Pfizer, Roche, Sanofi, UCB. N. Venhoff: Speaker for AbbVie, AstraZeneca, BMS, Boehringer-Ingelheim, Chugai, Celgene, GSK, Novartis, Pfizer, Janssen, Roche, UCB, Vifor. Consultant for AbbVie, AstraZeneca, Boehringer-Ingelheim, GSK, Novartis, Pfizer, Janssen, Roche, UCB, Vifor. Research support from AbbVie, Medac, Novartis, Pfizer. Member of recommendation initiative of AWMF for management of large vessel vasculitis. For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case. The supplement containing this article is not sponsored by industry.

References

    1. Bosch P, Bond M, Dejaco C et al (2023) Imaging in diagnosis, monitoring and outcome prediction of large vessel vasculitis: a systematic literature review and meta-analysis informing the 2023 update of the EULAR recommendations. RMD Open 9:e3379 - PMC - PubMed
    1. Dejaco C, Ramiro S, Bond M et al (2024) EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice: 2023 update. Ann Rheum Dis 83;741-751. 10.1136/ard-2023-224543 - PubMed
    1. Diamantopoulos AP, Haugeberg G, Lindland A et al (2016) The fast-track ultrasound clinic for early diagnosis of giant cell arteritis significantly reduces permanent visual impairment: towards a more effective strategy to improve clinical outcome in giant cell arteritis? Rheumatology 55:66–70 - PubMed
    1. Keller KK, Mukhtyar CB, Nielsen AW et al (2023) Recommendations for early referral of individuals with suspected polymyalgia rheumatica: an initiative from the international giant cell arteritis and polymyalgia rheumatica study group. Ann Rheum Dis Dec. 10.1136/ard-2023-225134 - PubMed
    1. Monti S, Bartoletti A, Bellis E, Delvino P et al (2020) Fast-track ultrasound clinic for the diagnosis of giant cell arteritis changes the prognosis of the disease but not the risk of future relapse. Front Med 7:589794 - PMC - PubMed

LinkOut - more resources