Limited utility of novel serological biomarkers in patients newly suspected of having giant cell arteritis

• Published in: International journal of rheumatic diseases Vol. 24; no. 6; pp. 781 - 788
• Main Authors: Sammel, Anthony M., Xue, Meilang, Karsten, Elisabeth, Little, Christopher B., Smith, Susan, Nguyen, Katherine, Laurent, Rodger
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.06.2021
• Subjects: Arteritis; Biomarkers; Biopsy; Computed tomography; Corticosteroids; Diagnosis; enzyme‐linked immunosorbent assay; Erythrocyte sedimentation rate; giant cell arteritis; immunoassay; Interferon; Interleukin 1; Interleukin 12; interleukin‐6; Pentraxins; Positron emission tomography; Procalcitonin; Serology; Vascular endothelial growth factor; Vasculitis; Von Willebrand factor; giant cell arteritis; vasculitis; interleukin-6; enzyme-linked immunosorbent assay; immunoassay
• DOI: 10.1111/1756-185X.14111
• ISSN: 1756-1841

Aim Diagnosing and monitoring vascular activity in giant cell arteritis (GCA) is difficult due to the paucity of specific serological biomarkers. We assessed the utility of 8 novel biomarkers in an inception cohort of newly suspected GCA patients. Method Consecutive patients were enrolled between May 2016 and December 2017. Serum was collected within 72 hours of commencing corticosteroids and at 6 months. It was analyzed for levels of intra‐cellular adhesion molecule 1, vascular endothelial growth factor (VEGF), pentraxin 3, von Willebrand factor and procalcitonin (5‐plex R&D Systems multiplex assay) and interleukin (IL)6, IL12 and interferon‐γ (high‐sensitivity 3‐plex ProcartaPlex multiplex assay). A GCA specific positron emission tomography / computed tomography (PET/CT) scan was performed at enrolment with uptake in each vascular territory graded and summed to derive a total vascular score (TVS). Results For the 63 patients enrolled, 12 (19%) had a final diagnosis of biopsy‐positive GCA and a further 9 had a clinical diagnosis of biopsy‐negative GCA. None of the 8 biomarkers was significantly higher in GCA patients compared with those with alternative diagnoses, or demonstrated a positive correlation with the PET/CT TVS. This was in contrast to the C‐reactive protein (CRP) and erythrocyte sedimentation rate (ESR) which were higher in the biopsy‐positive GCA cohort (P < .04) and showed weak positive correlations with the TVS (correlation coefficient 0.34, P < .01). Procalcitonin did not distinguish between GCA and infection. Concentrations of CRP, ESR, VEGF and pentraxin 3 decreased between diagnosis and 6 months in GCA patients. Conclusion This study did not identify new serological biomarkers to assist in diagnosing or assessing the vasculitis burden in GCA.