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  • GCA and Race: Is There a Correlation?

    By Lynda Seminara
    Selected and Reviewed By: Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, October 2019

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    Giant cell arteritis (GCA) is the most common vasculitis in adults and is linked to high rates of morbidity and mortality. Although its incidence in white populations has been studied extensively, little is known about its preponderance in other racial or ethnic groups. Gruener et al. explored the racial incidences of biopsy-proven GCA in a tertiary care facility that serves a substantial black population. They observed a similar rate of GCA in black and white patients.

    For this study, the authors identified all patients who underwent temporal artery biopsy (TAB) from July 2007 through September 2017 at the Wilmer Eye Institute in Baltimore. Self-reported data on race, sex, and age were tallied and compared with data for all other patients attending the hospital during the same period. Main outcomes were the estimated rates of biopsy-proven GCA among blacks and whites.

    Of the 586 patients who underwent TAB (mean age, 70.5 years; 423 [72.2%] women), 167 (28.5%) were black, 382 (65.2%) were white, and 37 (6.3%) were of other or unknown race. Crude annual incidence rates for biopsy-prov­en GCA were 2.9 per 100,000 blacks and 4.2 per 100,000 whites. Population-adjusted age- and sex-standardized incidence rates were 3.1 and 3.6 per 100,000 black and white patients, respectively (p = .70). The female-to-male incidence ratio was 1.9 (p = .03). The white-to-black incidence ratio was not significant (1.2; p = .66).

    Of the 573 individuals ≥50 years of age, 92 (16.1%) had biopsy-proven GCA. Of these, 14 were black (8.4% of tested black patients) and 75 were white (19.6% of tested white patients). The authors did not consciously apply different clinical criteria or thresholds for offering or performing TAB in the study population; therefore, the higher pretest probability among whites may suggest that the link between symptoms and disease is stronger in this racial group.

    Contrary to research suggesting that GCA is more common in whites and that its occurrence in blacks may be almost negligible, this study indicates that blacks and whites have a similar in­cidence of GCA. Therefore, the authors recommend that the clinical thresholds for diagnosing and managing GCA be the same for white and black pop­ulations. (See also related commentary by Michael K. Yoon, MD, and Joseph F. Rizzo III, MD, in the same issue.)

    The original article can be found here.