Giant cell arteritis: Commentary on recommendations of the French Study Group for Large Vessel Vasculitis (GEFA)
The recently created French Study Group for Large Vessel asculitis (GEFA, "Groupe d'Etude Franc ais des Arterites des gros aisseaux" is a multidisciplinary panel comprised of members ommitted to the care and study of patients with giant cell arteriis (GCA) While our understanding of the vasculitides has grown, uch remains unknown. Treatment is not curative and is associted with significant morbidity [1] In hoping to inform and guide ractitioners, GEFA members have attempted to achieve at least 0% consensus on recommendations for nomenclature, diagnosis nd treatment. For each of these topics there exists varying degrees f controversy, making a rigorous examination of available data nd provision of sound advice especially welcome. The iterative, onsensus seeking approach taken by GEFA members has been uccessful and is an important contribution for guiding medical ractice. In a field that thankfully continues to evolve, GEFA authors ave been cautious to indicate that their judgments and recomendations are provisional and should be updated over time. In hat vein, this important paper also provides the reader with a comass to conceive of future work that will enrich the state of the art f large vessel vasculitis (LVV) In regard to diagnostic recommendations, the authors' review ncludes 2 studies that address the utility of clinical features ighly suggestive of GCA, and that were also predictive of a ositive temporal artery (TA) biopsy. The presence of masseter uscle claudication, diplopia, new onset uncharacteristic/atypical eadaches and temporal artery abnormalities on physical examinaion significantly increased the probability of a positive TA biopsy. ombinations of features such as polymyalgia rheumatic (PMR)
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