Ponich Brett, Hartley Rebecca, Lafreniere Ann-Sophie, Temple-Oberle Claire F
Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Division of Plastic and Reconstructive Surgery, University of Calgary, Calgary, Alberta, Canada.
Plast Reconstr Surg Glob Open. 2022 May 20;10(5):e4185. doi: 10.1097/GOX.0000000000004185. eCollection 2022 May.
Temporal artery biopsy (TAB) is currently the gold standard procedure to diagnose giant cell arteritis. Despite low sensitivity, TAB is routinely performed even if a clinical diagnosis has already been made. The objective of this study was to determine the usefulness of TAB for giant cell arteritis management.
We performed a systematic review to identify studies that compared steroid treatment between TAB+ and TAB- patients. EMBASE, MEDLINE, and the Cochrane Central Register of Controlled Trials were searched from inception until April 4, 2020. Titles, abstracts, and full texts were reviewed by two independent reviewers and conflicts resolved by consensus. Studies reporting TAB result and steroid treatment were included. Information pertaining to steroid treatment was compared between TAB+ and TAB- groups. Steroid duration was compared by grouping patients in a less than 6 month group, a 6-24 month group, and a more than 24 month group.
An estimated 5288 abstracts were screened and 13 studies involving 1355 patients were included. Rate of prebiopsy steroid treatment was higher in TAB+ patients compared with TAB- patients [93% versus 63% ( < 0.001)]. The TAB+ group was more likely to be started on steroids prebiopsy [28% versus 8% ( < 0.001)]. TAB+ and TAB- patients had similar steroid duration for all groups [<6-month group 17% versus 19% (-0.596), the 6-24-month group 16% versus 19% (-0.596), and the >24-month group 66% versus 63% (-0.642)].
TAB results have minimal impact on treatment, and the utility should be reconsidered when a clinical diagnosis of giant cell arteritis is possible.
颞动脉活检（TAB）目前是诊断巨细胞动脉炎的金标准程序。尽管敏感性较低，但即使已经做出临床诊断，TAB仍常规进行。本研究的目的是确定TAB在巨细胞动脉炎管理中的实用性。
我们进行了一项系统评价，以识别比较TAB阳性和TAB阴性患者之间类固醇治疗的研究。从创刊至2020年4月4日检索了EMBASE、MEDLINE和Cochrane对照试验中央注册库。由两名独立的评审员审查标题、摘要和全文，并通过共识解决冲突。纳入报告TAB结果和类固醇治疗的研究。比较TAB阳性和TAB阴性组之间与类固醇治疗相关的信息。通过将患者分为少于6个月组、6至24个月组和超过24个月组来比较类固醇使用持续时间。
估计筛选了5288篇摘要，纳入了13项研究，涉及1355名患者。与TAB阴性患者相比，TAB阳性患者活检前类固醇治疗率更高[93%对63%（<0.001）]。TAB阳性组更有可能在活检前开始使用类固醇[28%对8%（<0.001）]。TAB阳性和TAB阴性患者在所有组中的类固醇使用持续时间相似[少于6个月组为17%对19%（-0.596），6至24个月组为16%对19%（-0.596），超过24个月组为66%对63%（-0.642）]。
TAB结果对治疗影响极小，当可能做出巨细胞动脉炎的临床诊断时，应重新考虑其效用。
