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Scientific article
Open access
English

Management of giant-cell arteritis in Switzerland: an online national survey

Published inSwiss medical weekly, vol. 153, no. 4, 40051
Publication date2023-04-03
First online date2023-04-03
Abstract

Aims of the study: To assess current practices in diagnosing, treating, and following-up giant-cell arteritis by specialists in Switzerland and to identify the main barriers to using diagnostic tools.

Methods: We performed a national survey of specialists potentially caring for patients with giant-cell arteritis. The survey was sent by email to all members of the Swiss Societies of Rheumatology and for Allergy and Immunology. A reminder was sent to nonresponders after 4 and 12 weeks. Its questions covered the following dimensions: respondents' main characteristics, diagnosis, treatment, and imaging's role during follow-up. The main study results were summarized using descriptive statistics.

Results: Ninety-one specialists, primarily aged 46-65 years (n = 53/89; 59%), working in academic or nonacademic hospitals or private practice, and treating a median of 7.5 (interquartile range [IQR]: 3-12) patients with giant-cell arteritis per year participated in this survey. Ultrasound of temporal arteries/large vessels (n = 75/90; 83%) and positron-emission-tomography-computed tomography (n = 52/91; 57%) or magnetic resonance imaging (n = 46/90; 51%) of the aorta/extracranial arteries were the most common techniques used to diagnose giant-cell arteritis with cranial or large vessel involvement, respectively. Most participants reported a short time to obtain imaging tests or arterial biopsy. The glucocorticoid tapering scheme, glucocorticoid-sparing agent, and glucocorticoid-sparing treatment duration varied among the participants. Most physicians did not follow a predefined repeat imaging scheme for follow-up and mainly relied on structural changes (vascular thickening, stenosis, or dilatation) to drive treatment choice.

Conclusions: This survey indicates that imaging and temporal biopsy are rapidly accessible for diagnosing giant-cell arteritis in Switzerland but highlights heterogeneous practice in many disease management areas.

eng
Keywords
  • Giant Cell Arteritis / diagnostic imaging
  • Giant Cell Arteritis / drug therapy
  • Glucocorticoids / therapeutic use
  • Humans
  • Positron Emission Tomography Computed Tomography
  • Switzerland
  • Temporal Arteries
Citation (ISO format)
IUDICI, Michele et al. Management of giant-cell arteritis in Switzerland: an online national survey. In: Swiss medical weekly, 2023, vol. 153, n° 4, p. 40051. doi: 10.57187/smw.2023.40051
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ISSN of the journal1424-3997
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