Kivitalo Lauri, Taimen Kirsi, Sokka-Isler Tuulikki, Kerola Anne, Rautavaara Joonas, Pirilä Laura, Kauppi Markku, Malila Joel, Haara Laura, Ryyppö Laura, Kotijärvi Taina, Saarenketo Panu, Saarivaara Hannu, Siltanen Juho, Helminen Mika, Rutanen Jarno, Isomäki Pia
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Department of Internal Medicine, Seinäjoki Central Hospital, Wellbeing Services County of South Ostrobothnia, Seinäjoki, Finland.
Rheumatol Adv Pract. 2025 May 15;9(2):rkaf055. doi: 10.1093/rap/rkaf055. eCollection 2025.
To study the annual incidence, diagnostic methods used and clinical presentation of giant cell arteritis (GCA) over time in Finland.
Newly diagnosed GCA patients from 2010 to 2020 were retrospectively identified from four healthcare districts in Finland. Medical records were reviewed and data on incidence, diagnostic methods, phenotype [cranial large vessel (LV)-GCA] and clinical presentation were analysed.
We identified 602 newly diagnosed GCA patients. The annual incidence was 9.0 cases/100 000 persons (95% CI 8.3, 9.7) ≥50 years of age and was significantly higher in the period 2016-2020 compared with the period 2010-2015 [11.3 (95% CI 10.1, 12.5) 7.0 (95% CI 6.2, 7.9), < 0.001]. Imaging- or biopsy-confirmed diagnosis was recorded in 75% of GCA patients, while 25% had a clinical diagnosis. The proportion of imaging- or biopsy-confirmed diagnoses increased over time [64.7% (2010-2015) 82.2% (2016-2020)] while that of clinical diagnoses decreased. The use of imaging methods increased while the use of temporal artery biopsies decreased between the two time periods. LV-GCA was discovered more often in the period 2016-2020 when compared with 2010-2015 (34.0% 19.3% of patients).
The incidence of GCA increased during the study period, as well as the proportion of imaging- or biopsy-confirmed diagnoses, probably due to more frequent use of advanced imaging methods. Additionally, patients with LV-GCA were more commonly identified.
研究芬兰巨细胞动脉炎(GCA)的年发病率、所采用的诊断方法及临床表现随时间的变化情况。
从芬兰四个医疗区回顾性识别出2010年至2020年新诊断的GCA患者。查阅病历并分析发病率、诊断方法、表型[颅部大血管(LV)-GCA]及临床表现的数据。
我们识别出602例新诊断的GCA患者。年龄≥50岁人群的年发病率为9.0例/10万人(95%置信区间8.3,9.7),2016 - 2020年期间显著高于2010 - 2015年期间[11.3(95%置信区间10.1,12.5)对7.0(95%置信区间6.2,7.9),P < 0.001]。75%的GCA患者记录有影像学或活检确诊诊断,而25%为临床诊断。影像学或活检确诊诊断的比例随时间增加[2010 - 2015年为64.7%,2016 - 2020年为82.2%],而临床诊断的比例下降。两个时间段之间,影像学方法的使用增加,而颞动脉活检的使用减少。与2010 - 2015年相比,2016 - 2020年期间更常发现LV - GCA(患者比例分别为34.0%和19.3%)。
在研究期间,GCA的发病率以及影像学或活检确诊诊断的比例均有所增加,这可能归因于更频繁地使用先进的影像学方法。此外,LV - GCA患者被更普遍地识别出来。