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Original article

Vol. 153 No. 4 (2023)

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

  • Michele Iudici
  • Andrea Katharina Hemmig
  • Mihaela Stegert
  • Delphine Sophie Courvoisier
  • Sabine Adler
  • Mike Oliver Becker
  • Christoph T. Berger
  • Diana Dan
  • Axel Finckh
  • Alfred Mahr
  • Thomas Neumann
  • Stephan Reichenbach
  • Camillo Ribi
  • Luca Seitz
  • Peter Villiger
  • Lukas Wildi
  • Thomas Daikeler
  • on behalf of Giant Cell Arteritis SCQM Study Group
DOI
https://doi.org/10.57187/smw.2023.40051
Cite this as:
Swiss Med Wkly. 2023;153:40051
Published
03.04.2023

Summary

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.

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