A glossary of signs and symptoms of giant cell arteritis

OBJECTIVES: This study seeks to create consensus-based definitions of signs and symptoms of giant cell arteritis (GCA) for use by health care professionals, primarily in research settings. METHODS: Core definitions of signs and symptoms of GCA were extracted from 11 randomised controlled trials of GCA previously reviewed in a systematic literature review conducted in the context of the development of response criteria for GCA. This information was supplemented by definitions from other sources, such as rheumatology textbooks. A 2-round Delphi was performed within an international task force (32 members from 11 countries). The first round aimed to obtain consensus on the descriptive terms defining each sign or symptom, and round 2 rated the importance of these terms. Based on the Delphi study method, preliminary definitions were developed. In 4 online meetings, results of the Delphi were reviewed, and a consensus was achieved on final definitions. RESULTS: Twenty-nine signs and symptoms of GCA were reviewed. Six signs or symptoms of GCA had previously been defined in the literature. A high level of agreement was reached on the definition of 23 signs and symptoms with the following 12 considered characteristic of GCA: headache, temporal artery abnormalities, scalp tenderness, scalp necrosis, jaw claudication, tongue claudication, tongue necrosis, amaurosis fugax, permanent vision loss, fever, limb claudication, and blood pressure inequality. CONCLUSIONS: A glossary of definitions for 23 signs and symptoms of GCA was developed through a consensus process involving international experts.