Temporal Artery Biopsy in Steroid-Treated Patients with Suspected Giant Cell Arteritis

In patients with suspected giant cell arteritis (GCA), steroids often are started before confirmation of the diagnosis by temporal artery biopsy. To maximize the yield of biopsy, the American College of Rheumatology recommends obtaining the biopsy within 2 weeks of starting steroid therapy, but this recommendation is labeled as “conditional” with “low level of evidence” (Arthritis Rheumatol 2021; 73:1349).

In a retrospective study from a Canadian referral center, researchers examined data on 223 patients with suspected GCA who underwent temporal artery biopsy; 89% of patients had started steroid therapy at varying intervals prior to biopsy. In a week-by-week analysis through the first 6 weeks after steroid exposure, the yield of biopsy was r…