46 Evaluating Clinical Outcomes in Temporal Artery Biopsy: A Retrospective Observational Study

Abstract

Abstract Aim Giant cell arteritis (GCA) is an inflammatory vasculopathy affecting large and medium calibre arteries, with temporal artery biopsy (TAB) constituting an important diagnostic component. The aim of this study was to analyse local practice in TAB and assess clinical outcomes with reference to current guidelines. Method All patients undergoing TAB in our institution between April 2018 and March 2021 were retrospectively studied and the American College of Rheumatology (ACR) score recorded. Results 124 patients were included in the study. The female to male ratio was 2.2:1 and average age was 71±10 years. 95 patients presented with temporal artery signs and headache respectively. The mean time from steroid commencement to TAB was 6 days (range 0–36 days). 23 biopsies were positive (median ACR score of 4, range 2–4, excluding pathology result) – these patients were treated with steroids. 98 biopsies were negative or non-specific; most stopped steroid treatment, however 30 patients were clinically GCA and continued therapy (median ACR score of 3, range 2–4). Three patients were never prescribed steroids (median ACR score of 2). Conclusions GCA is a clinical diagnosis guided by symptoms and signs, inflammatory biochemical markers, and medium artery biopsy. The provisional ACR scoring is highly suggestive of the outcome of TAB.