The fragility of randomized controlled trials in large vessel vasculitis.

The fragility of randomized controlled trials (RCTs) of large vessel vasculitis (LVV) - defined as the minimum number of outcome events that would need to change to reverse the trial's conclusions - has not been comprehensively studied. We identified relevant RCTs with a systematic literature review till April 2025. The fragility index (FI)/ reverse fragility index (RFI) and fragility quotient (FQ, i.

Exploring the limit of image resolution for human expert classification of vascular ultrasound images in giant cell arteritis and healthy subjects: the GCA-US-AI project.

Objectives: Prompt diagnosis of giant cell arteritis (GCA) with ultrasound is crucial for preventing severe ocular and other complications, yet expertise in ultrasound performance is scarce. The development of an artificial intelligence (AI)-based assistant that facilitates ultrasound image classification and helps to diagnose GCA early promises to close the existing gap. In the projection of the planned AI, this study investigates the minimum image resolution required for human experts to reliably classify ultrasound images of arteries commonly affected by GCA for the presence or absence of GCA.

Adrenal insufficiency in giant cell arteritis.

Objectives: To ascertain the frequency of adrenal insufficiency in patients with GCA treated using the Norwich prednisolone regimen.

Methods: Consecutive patients diagnosed with GCA between 1 January 2012 and 31 May 2022 were included. All patients were treated with the Norwich prednisolone regimen, educated about the benefits and risks of long-term prednisolone use and followed up in dedicated vasculitis clinics.

An analysis of the first relapse in giant cell arteritis using ultrasonography.

Objectives: To compare the nature of the first relapse of giant cell arteritis to baseline disease using ultrasonography METHODS: Patients with suspected new and relapsing giant cell arteritis between January 2017 and December 2023 underwent protocolised ultrasonography to examine the superficial temporal and axillary arteries plus other areas as clinically indicated. The nature of disease was categorised as affecting superficial temporal, axillary or mixed disease. Patients where other arteries were needed for diagnosis or relapse were categorised separately.

Incidence of ANCA-associated vasculitis and polyarteritis nodosa in Norfolk, UK, from 2011 to 2020.

Objective: The aim of this study was to report the annual and age-specific incidence of AAV and PAN in the adult population of Norfolk County, UK.

Methods: Individuals newly diagnosed with AAV or PAN between 1 January 2011 and 31 December 2020 residing in the postal areas of NR1-NR30 were included. Patients were classified according to the European Medicines Agency algorithm.

A history of polymyalgia rheumatica: a narrative review.

Polymyalgia rheumatica (PMR) is characterized by stiffness and pain in the shoulders, hips and neck and presents most commonly in the eighth decade. It can coexist with giant cell arteritis and the two diseases may share some pathophysiological mechanisms. This narrative review considers present-day ideas about PMR in a historical context, from the first names and descriptions of this disease entity, via successive generations of classification criteria sets, and finally to implications for clinical diagnosis.

Ultrasonography-led multimodal diagnostic pathway for giant cell arteritis.

Objectives: This study aims to establish the sensitivity and negative predictive value of a multimodal pathway incorporating ultrasonography, 18-fluorodeoxyglucose labelled PET-CT and temporal artery biopsy for the diagnosis of giant cell arteritis.

Methods: In total, 1000 consecutive referrals for a new diagnosis of giant cell arteritis were analysed. All patients had a protocolized examination.

Management of systemic lupus erythematosus: a systematic literature review informing the 2023 update of the EULAR recommendations.

Objectives: To analyse the new evidence (2018-2022) for the management of systemic lupus erythematosus (SLE) to inform the 2023 update of the European League Against Rheumatism (EULAR) recommendations.

Methods: Systematic literature reviews were performed in the Medline and the Cochrane Library databases capturing publications from 1 January 2018 through 31 December 2022, according to the EULAR standardised operating procedures. The research questions focused on five different domains, namely the benefit/harm of SLE treatments, the benefits from the attainment of remission/low disease activity, the risk/benefit from treatment tapering/withdrawal, the management of SLE with antiphospholipid syndrome and the safety of immunisations against varicella zoster virus and SARS-CoV2 infection.

Recommendations for early referral of individuals with suspected polymyalgia rheumatica: an initiative from the international giant cell arteritis and polymyalgia rheumatica study group.

Objective: To develop international consensus-based recommendations for early referral of individuals with suspected polymyalgia rheumatica (PMR).

Methods: A task force including 29 rheumatologists/internists, 4 general practitioners, 4 patients and a healthcare professional emerged from the international giant cell arteritis and PMR study group. The task force supplied clinical questions, subsequently transformed into Population, Intervention, Comparator, Outcome format.

EULAR recommendations for the management of systemic lupus erythematosus: 2023 update.

Objectives: To update the EULAR recommendations for the management of systemic lupus erythematosus (SLE) based on emerging new evidence.

Methods: An international Task Force formed the questions for the systematic literature reviews (January 2018-December 2022), followed by formulation and finalisation of the statements after a series of meetings. A predefined voting process was applied to each overarching principle and recommendation.

Incidence of primary large vessel vasculitis in Norfolk, UK from 2011 to 2020.

Objectives: To report the annual incidence of primary large vessel vasculitis (LVV) in the adult population of Norfolk County, UK, including giant cell arteritis (GCA) (in those ≥50 years) and Takayasu arteritis (TAK).

Methods: Individuals diagnosed by histology or imaging who lived in NR1-NR30 postcode districts were included. Validated criteria from 1990 and 2022 were applied for final classification.

Frequency of visual involvement in a 10-year interdisciplinary cohort of patients with giant cell arteritis.

Background: We present the largest study of the frequency and nature of visual complications in a cohort of 350 patients consecutively diagnosed with giant cell arteritis (GCA).

Methods: All individuals were assessed using structured forms and diagnosed using imaging or biopsy. A binary logistic regression model was used to analyse data for predicting visual loss.

EULAR recommendations for the management of ANCA-associated vasculitis: 2022 update.

Background: Since the publication of the EULAR recommendations for the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in 2016, several randomised clinical trials have been published that have the potential to change clinical care and support the need for an update.

Methods: Using EULAR standardised operating procedures, the EULAR task force undertook a systematic literature review and sought opinion from 20 experts from 16 countries. We modified existing recommendations and created new recommendations.

The provisional OMERACT ultrasonography score for giant cell arteritis.

Objectives: To develop an Outcome Measures in Rheumatology (OMERACT) ultrasonography score for monitoring disease activity in giant cell arteritis (GCA) and evaluate its metric properties.

Methods: The OMERACT Instrument Selection Algorithm was followed. Forty-nine members of the OMERACT ultrasonography large vessel vasculitis working group were invited to seven Delphi rounds.