Presentation (CTI)

OBJECTIVES: Giant cell arteritis (GCA) is a systemic inflammatory disorder affecting medium and large arteries, commonly occurring in individuals ≥50 years. Inflammation narrows arterial walls, reducing blood flow and causing various symptoms and complications. Although glucocorticoids are the standard treatment, alternatives are needed to minimize side-effects and maintain remission. The objective was to assess the global burden of GCA and summarize the associated published epidemiological data.
METHODS: A literature review conducted in February 2024 included Embase, MEDLINE, MEDLINE-In Process, and the Cochrane library, supplemented by hand searches at key conferences. English language studies reporting on the prevalence, incidence, and risk factors of GCA were included. Study selection, data extraction, and reporting adhered to current best practices.
RESULTS: 63 publications were reviewed. Reported global pooled prevalence was 51.74/100,000 individuals >50 years of age. Among the age group at risk, the reported U.S. prevalence was 204/100,000, with higher rates in Northern Europe compared to Southern Europe. The global annual incidence was estimated at 10/100,000 person-years among those >50 years of age. The highest incidence rates per 100,000 person-years were in Scandinavia (21.57), North/South America (10.89), Oceania (7.85), and Europe (7.26). Incidence and prevalence were higher in females and peaked in individuals ≥70 years of age. Variations in epidemiological data could be attributed to differences in classification and diagnostic criteria, and genetic or geographical factors. Healthcare access disparities could lead to underdiagnosis or misdiagnosis. Non-modifiable risk factors included older age, female gender, Scandinavian/Northern European ancestry, and polymyalgia rheumatica. Modifiable risk factors were smoking, hyperlipidemia, and infections (respiratory and herpes zoster).
CONCLUSIONS: With an aging population the morbidity associated with GCA could significantly increase. Changes in healthcare policies and diagnostic coding practices may also influence reported incidence and prevalence. Understanding GCA’s evolving epidemiology is crucial for assessing disease burden and developing effective treatment strategies.