Phénotype et complications cliniques de l'artérite à cellules géantes avec atteinte des gros vaisseaux: revue systématique et méta-analyse

Translated title of the contribution: Clinical phenotype and complications of large vessel giant cell arteritis: A systematic review and meta-analysis

Suellen Anne Lyne, Carlee Ruediger, Susan Lester, Gursimran Kaur, Lisa Stamp, Ernst Michael Shanahan, Catherine Louise Hill

Research output: Contribution to journalReview articlepeer-review



Giant cell arteritis (GCA) is a heterogenous systemic granulomatous vasculitis involving the aorta and any of its major tributaries. Despite increased awareness of large vessel (LV) involvement, studies reporting incidence, clinical characteristics and complications of large-vessel GCA (LV-GCA) show conflicting results due to inconsistent disease definitions, differences in study methodologies and the broad spectrum of clinical presentations. The aim of this systematic literature review was to better define LV-GCA based on the available literature and identify distinguishing characteristics that may differentiate LV-GCA patients from those with limited cranial disease.


Published studies indexed in MEDLINE and EMBASE were searched from database inception to 7 May 2021. Studies were included if they presented cohort or cross-sectional data on a minimum of 25 patients with LV-GCA. Control groups were included if data was available on patients with limited cranial GCA (C-GCA). Data was quantitatively synthesised with application of a random effects meta-regression model, using Stata.


The search yielded 3488 studies, of which 46 were included. Diagnostic criteria for LV-GCA differed between papers, but were typically dependent on imaging or histopathology. Patients with LV-GCA were generally younger at diagnosis compared to C-GCA patients (mean age difference –4.53 years), had longer delay to diagnosis (mean difference 3.03 months) and lower rates of positive temporal artery biopsy (OR : 0.52 [95% CI : 0.3, 0.91]). Fewer LV-GCA patients presented with cranial manifestations and only 53% met the 1990 ACR Classification Criteria for GCA. Vasculitis was detected most commonly in the thoracic aorta, followed by the subclavian, brachiocephalic trunk and axillary arteries. The mean cumulative prednisolone dose at 12-months was 6056.5 mg for LV-GCA patients, relapse rates were similar between LV- and C-GCA patients, and 12% of deaths in LV-GCA patients could be directly attributed to an LV complication.


Patients with LV-GCA have distinct disease features when compared to C-GCA, and this has implications on diagnosis, treatment strategies and surveillance of long-term sequalae.

Translated title of the contributionClinical phenotype and complications of large vessel giant cell arteritis: A systematic review and meta-analysis
Original languageFrench
Pages (from-to)552-564
Number of pages13
JournalRevue du Rhumatisme (Edition Francaise)
Issue number5
Early online date15 Jul 2023
Publication statusPublished - Oct 2023


  • Artérite à cellules géantes
  • Extra-cranial
  • Extra-crânienne
  • Giant cell arteritis
  • Large vessel vasculitis
  • Meta-analysis
  • Méta-analyse
  • Revue systématique de la littérature
  • Systematic literature review
  • Vascularite des gros vaisseaux


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