Background
Giant cell arteritis (GCA) is the commonest vasculitis, affecting people aged 50 years and over.1 It is most common in white North European populations and more common in women than men.2, 3 GCA is two to five times more prevalent in Northern than Southern Europe, with Scandinavian countries demonstrating highest incidence rates. Incidence in other ethnic groups has infrequently been addressed, with a noticeable paucity of data from East-Asian, Indian subcontinent, African and South American populations.3, 4 In Japan, the incidence of GCA is 1.47 per 100,000.5
In the UK, the overall age-adjusted incidence rate is 2.2 per 10,000 person-years, with marked regional variation, with the condition being more common in the south than the north.6
Our study aims to assess the demographic variation of GCA amongst the population of Sheffield, England, being near the geographical midpoint of the UK.
Methods
This is a hospital-based, retrospective cohort study. Patients diagnosed with GCA (both temporal artery biopsy proven and negative) in the Sheffield Teaching Hospital catchment between the years 2017–2019 were identified from surgical operating lists. Clinical information was extracted from patients' medical notes and clinic letters. The ethnicity of each patient within the study group was determined by self-reported ethnicity on their medical record, stratified by the Ethnic Category Codes 2001.
Results
In our cohort we identified 112 patients treated for giant cell arteritis. 55 patients had a clinical diagnosis and 57 were biopsy positive. The median age of the cohort was 75.5 (51–90), median Southend probability score was 14 (6–21), and median CRP was 53 mg/L (0.4–278). 31.3% had visual disturbances at presentation.
Patients investigated for GCA were predominantly white British or Irish (94.3%). A minority of patients identified themselves as Asian or Asian British (1.7%), Black or Black British (1.7%), and any other ethnic groups (1.1%). Only 31.3% of the white British and Irish population studied had a positive temporal artery biopsy. Of the eight patients belonging to other ethnic groups only one patient had a positive temporal artery biopsy.
Conclusion
Our study demonstrated that the incidence of GCA in different ethnic groups is aligned with other European populations. GCA was seen most common in white populations, and infrequent in other ethnic groups.
References
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