Abstract
Purpose :
The 1990 ACR criteria remains the gold standard in diagnosing giant cell arteritis. However, on this five-point scale, a temporal artery biopsy (TAB) is required. The primary aim of this study was to analyse patients’ presenting clinical and laboratory features to formulate a new six-point scoring system (the TABLET score) that may have diagnostic and prognostic implications and stratify the need for biopsy. We also aimed to assess diagnostic yield of TABs and colour duplex ultrasound (US).
Methods :
A retrospective, single-centre study of patients who underwent a TAB for suspected Giant Cell Arteritis (GCA) over a 5-year period was conducted. Baseline data collected included patient demographics, blood tests and presenting signs and symptoms. TABs were assessed for histology outcome and segment length, whereas US findings were assessed for hallmarks suggestive of GCA. A record was made of patient treatment length with oral steroids, ≥6 months (treated as GCA) or <6 months (not treated as GCA).
Results :
118 TABs were performed with a 22.0% positivity rate. Signs and symptoms significantly associated with presumed GCA were new onset headache (74.6%), temporal artery abnormality (55.5%), myalgia (54.0%) and jaw claudication (42.9%). Patients with a TABLET scores of 1 (0% treated) and 4-6 (91.1% treated) were deemed of significant low or high risk, respectively, to not require biopsy.
Conclusions :
The TABLET score may determine the necessity of a TAB and predict likelihood of the need for extended oral steroid treatment for patients in whom GCA may be clinically ruled in or out.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.