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Original Article
Evaluating the diagnostic accuracy of the 2022 ACR/EULAR classification criteria for giant cell arteritis in routine clinical practice
Abstract
Aims: The 2022 American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) classification criteria for giant cell arteritis (GCA) were developed to enhance diagnostic accuracy by incorporating advanced imaging modalities and addressing large vessel involvement. This study evaluates the performance of these criteria in routine clinical care.
Methods: This study was retrospective and single-center. The results included 25 GCA patients routinely followed at a tertiary rheumatology center from March 2017 to January 2024. The accuracy, sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic (ROC) curve (AUC) of the classification criteria were compared.
Results: The sensitivity (92.0%), specificity (92.9%), positive predictive value (92.0%), negative predictive value (92.9%), accuracy (92.4%) and AUC (0.979 (0.925-0.998)) of the 2022 ACR/EULAR classification criteria for GCA were higher than those of the 1990 ACR classification criteria for GCA (88.0%, 85.7%, 84.6%, 88.9% and 86.8%, respectively), and the difference in AUC was statistically significant (0.871 (0.770-0.973), p<0.001).
Conclusion: These findings indicate that the 2022 ACR/EULAR criteria significantly improve the sensitivity and maintain adequate specificity compared to the 1990 criteria, making them a valuable tool for diagnosing GCA in clinical practice. The new classification criteria will help to select the right patients and will reduce clinical errors.

Keywords : Giant cell arteritis, vasculitis, classification criteria

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1. Dejaco C, Brouwer E, Mason JC, et al. Giant cell arteritis and polymyalgia rheumatica: current challenges and opportunities. Nat Rev Rheumatol. 2017;13(10):578-592. doi:10.1038/nrrheum.2017.142
2. Kermani TA, Schäfer VS, Crowson CS, et al. Increase in age at onset of giant cell arteritis: a population-based study. Ann Rheum Dis. 2010; 69(4):780-781. doi:10.1136/ard.2009.111005
3. Bull Haaversen AC, Brekke LK, Kermani TA, et al. Extended ultrasound examination identifies more large vessel involvement in patients with giant cell arteritis. Rheumatology. 2023;62(5):1887-1894. doi:10.1093/rheumatology/keac478
4. Hunder GG, Bloch DA, Michel BA, et al. The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum. 1990;33(8):1122-1128. doi:10.1002/art.1780330810
5. Seeliger B, Sznajd J, Robson JC, et al. Are the 1990 American College of Rheumatology vasculitis classification criteria still valid? Rheumatology. 2017;56(7):1154-1161. doi:10.1093/rheumatology/kex075
6. Schmidt WA, Dasgupta B, Luqmani R, et al. A Multicentre, randomised, double-blind, placebo-controlled, parallel-group study to evaluate the efficacy and safety of sirukumab in the treatment of giant cell arteritis. Rheumatol Ther. 2020;7(4):793-810. doi:10.1007/s40744-020-00227-2
7. Venhoff N, Schmidt WA, Lamprecht P, et al. Efficacy and safety of secukinumab in patients with giant cell arteritis: study protocol for a randomized, parallel group, double-blind, placebo-controlled phase II trial. Trials. 2021;22(1):543. doi:10.1186/s13063-021-05520-1
8. Ponte C, Grayson PC, Robson JC, et al. 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis. Arthritis Rheumatol. 2022;74(12):1881-1889. doi:10.1002/art.42325
9. Opri?-Belinski D, Cobilinschi CO, Saulescu I. Current perspectives in giant cell arteritis: can we better connect pathogenesis and treatment? Medicina (B Aires). 2024;60(3):400. doi:10.3390/medicina60030400
10. Molina-Collada J, Castrejón I, Monjo I, et al. Performance of the 2022 ACR/EULAR giant cell arteritis classification criteria for diagnosis in patients with suspected giant cell arteritis in routine clinical care. RMD Open. 2023;9(2):e002970. doi:10.1136/rmdopen-2022-002970
11. Hemmig AK, Aschwanden M, Imfeld S, Berger CT, Daikeler T. A diagnostic performance study of the 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis in a cohort of patients presenting with suspected giant cell arteritis. Arthritis Rheumatol. 2023;75(6):1075-1077. doi:10.1002/art.42440
12. Narváez J, Estrada P, Vidal-Montal P, Nolla JM. Performance of the new 2022 ACR/EULAR classification criteria for giant cell arteritis in clinical practice in relation to its clinical phenotypes. Autoimmun Rev. 2023;22(10):103413. doi:10.1016/j.autrev.2023.103413
13. Sanchez-Martin J, Medina-Del Valle J, Loricera J, et al. AB0733 concordance between the 1990 ACR classification criteria and the new 2022 ACR/EULAR 2022 criteria in giant cell arteritis. Annals Rheumatic Dis. 2023;82:p.1572.2-1573. doi:10.1136/annrheumdis-2023-eular.6144
14. Bergner R, Schulz P, Friedrich J. AB0704 evaluation of the of the 2022 ACR/EULAR classification criteria for GCA in a German patient cohort. Scientific abstracts. Annals Rheumatic Dis. 2023;82:1555-1556. doi:10.1136/annrheumdis-2023-eular.2102
15. Andel P, Diamantopoulos A, Myklebust G, Haugeberg G. Vasculitis distribution and clinical characteristics in giant cell arteritis: a retrospective study using the new 2022 ACR/EULAR classification criteria. Front Med (Lausanne). 2023;10:1286601. doi:10.3389/fmed. 2023.1286601
16. Nieuwland M van, Bon L van, Vermeer M, et al. External validation of the 2022 ACR/EULAR classification criteria in patients with suspected giant cell arteritis in a Dutch fast-track clinic. RMD Open. 2023;9(3): e003080. doi:10.1136/rmdopen-2023-003080
17. Sandal Uzun G, Gokoz O, Heper A, et al. AB0756 identification of histopathologic findings of patients with giant cell arteritis: a multicentre study in the era of 2022 ACR/EULAR classifıcation criteria for GCA. Annals Rheumatic Dis. 2023;2(Suppl 1):p.1584.1-1585. doi:10.1136/annrheumdis-2023-eular.1935
1. Dejaco C, Brouwer E, Mason JC, et al. Giant cell arteritis and polymyalgia rheumatica: current challenges and opportunities. Nat Rev Rheumatol. 2017;13(10):578-592. doi:10.1038/nrrheum.2017.142
2. Kermani TA, Schäfer VS, Crowson CS, et al. Increase in age at onset of giant cell arteritis: a population-based study. Ann Rheum Dis. 2010; 69(4):780-781. doi:10.1136/ard.2009.111005
3. Bull Haaversen AC, Brekke LK, Kermani TA, et al. Extended ultrasound examination identifies more large vessel involvement in patients with giant cell arteritis. Rheumatology. 2023;62(5):1887-1894. doi:10.1093/rheumatology/keac478
4. Hunder GG, Bloch DA, Michel BA, et al. The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum. 1990;33(8):1122-1128. doi:10.1002/art.1780330810
5. Seeliger B, Sznajd J, Robson JC, et al. Are the 1990 American College of Rheumatology vasculitis classification criteria still valid? Rheumatology. 2017;56(7):1154-1161. doi:10.1093/rheumatology/kex075
6. Schmidt WA, Dasgupta B, Luqmani R, et al. A Multicentre, randomised, double-blind, placebo-controlled, parallel-group study to evaluate the efficacy and safety of sirukumab in the treatment of giant cell arteritis. Rheumatol Ther. 2020;7(4):793-810. doi:10.1007/s40744-020-00227-2
7. Venhoff N, Schmidt WA, Lamprecht P, et al. Efficacy and safety of secukinumab in patients with giant cell arteritis: study protocol for a randomized, parallel group, double-blind, placebo-controlled phase II trial. Trials. 2021;22(1):543. doi:10.1186/s13063-021-05520-1
8. Ponte C, Grayson PC, Robson JC, et al. 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis. Arthritis Rheumatol. 2022;74(12):1881-1889. doi:10.1002/art.42325
9. Opri?-Belinski D, Cobilinschi CO, Saulescu I. Current perspectives in giant cell arteritis: can we better connect pathogenesis and treatment? Medicina (B Aires). 2024;60(3):400. doi:10.3390/medicina60030400
10. Molina-Collada J, Castrejón I, Monjo I, et al. Performance of the 2022 ACR/EULAR giant cell arteritis classification criteria for diagnosis in patients with suspected giant cell arteritis in routine clinical care. RMD Open. 2023;9(2):e002970. doi:10.1136/rmdopen-2022-002970
11. Hemmig AK, Aschwanden M, Imfeld S, Berger CT, Daikeler T. A diagnostic performance study of the 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis in a cohort of patients presenting with suspected giant cell arteritis. Arthritis Rheumatol. 2023;75(6):1075-1077. doi:10.1002/art.42440
12. Narváez J, Estrada P, Vidal-Montal P, Nolla JM. Performance of the new 2022 ACR/EULAR classification criteria for giant cell arteritis in clinical practice in relation to its clinical phenotypes. Autoimmun Rev. 2023;22(10):103413. doi:10.1016/j.autrev.2023.103413
13. Sanchez-Martin J, Medina-Del Valle J, Loricera J, et al. AB0733 concordance between the 1990 ACR classification criteria and the new 2022 ACR/EULAR 2022 criteria in giant cell arteritis. Annals Rheumatic Dis. 2023;82:p.1572.2-1573. doi:10.1136/annrheumdis-2023-eular.6144
14. Bergner R, Schulz P, Friedrich J. AB0704 evaluation of the of the 2022 ACR/EULAR classification criteria for GCA in a German patient cohort. Scientific abstracts. Annals Rheumatic Dis. 2023;82:1555-1556. doi:10.1136/annrheumdis-2023-eular.2102
15. Andel P, Diamantopoulos A, Myklebust G, Haugeberg G. Vasculitis distribution and clinical characteristics in giant cell arteritis: a retrospective study using the new 2022 ACR/EULAR classification criteria. Front Med (Lausanne). 2023;10:1286601. doi:10.3389/fmed. 2023.1286601
16. Nieuwland M van, Bon L van, Vermeer M, et al. External validation of the 2022 ACR/EULAR classification criteria in patients with suspected giant cell arteritis in a Dutch fast-track clinic. RMD Open. 2023;9(3): e003080. doi:10.1136/rmdopen-2023-003080
17. Sandal Uzun G, Gokoz O, Heper A, et al. AB0756 identification of histopathologic findings of patients with giant cell arteritis: a multicentre study in the era of 2022 ACR/EULAR classifıcation criteria for GCA. Annals Rheumatic Dis. 2023;2(Suppl 1):p.1584.1-1585. doi:10.1136/annrheumdis-2023-eular.1935
1. Dejaco C, Brouwer E, Mason JC, et al. Giant cell arteritis and polymyalgia rheumatica: current challenges and opportunities. Nat Rev Rheumatol. 2017;13(10):578-592. doi:10.1038/nrrheum.2017.142
2. Kermani TA, Schäfer VS, Crowson CS, et al. Increase in age at onset of giant cell arteritis: a population-based study. Ann Rheum Dis. 2010; 69(4):780-781. doi:10.1136/ard.2009.111005
3. Bull Haaversen AC, Brekke LK, Kermani TA, et al. Extended ultrasound examination identifies more large vessel involvement in patients with giant cell arteritis. Rheumatology. 2023;62(5):1887-1894. doi:10.1093/rheumatology/keac478
4. Hunder GG, Bloch DA, Michel BA, et al. The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum. 1990;33(8):1122-1128. doi:10.1002/art.1780330810
5. Seeliger B, Sznajd J, Robson JC, et al. Are the 1990 American College of Rheumatology vasculitis classification criteria still valid? Rheumatology. 2017;56(7):1154-1161. doi:10.1093/rheumatology/kex075
6. Schmidt WA, Dasgupta B, Luqmani R, et al. A Multicentre, randomised, double-blind, placebo-controlled, parallel-group study to evaluate the efficacy and safety of sirukumab in the treatment of giant cell arteritis. Rheumatol Ther. 2020;7(4):793-810. doi:10.1007/s40744-020-00227-2
7. Venhoff N, Schmidt WA, Lamprecht P, et al. Efficacy and safety of secukinumab in patients with giant cell arteritis: study protocol for a randomized, parallel group, double-blind, placebo-controlled phase II trial. Trials. 2021;22(1):543. doi:10.1186/s13063-021-05520-1
8. Ponte C, Grayson PC, Robson JC, et al. 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis. Arthritis Rheumatol. 2022;74(12):1881-1889. doi:10.1002/art.42325
9. Opri?-Belinski D, Cobilinschi CO, Saulescu I. Current perspectives in giant cell arteritis: can we better connect pathogenesis and treatment? Medicina (B Aires). 2024;60(3):400. doi:10.3390/medicina60030400
10. Molina-Collada J, Castrejón I, Monjo I, et al. Performance of the 2022 ACR/EULAR giant cell arteritis classification criteria for diagnosis in patients with suspected giant cell arteritis in routine clinical care. RMD Open. 2023;9(2):e002970. doi:10.1136/rmdopen-2022-002970
11. Hemmig AK, Aschwanden M, Imfeld S, Berger CT, Daikeler T. A diagnostic performance study of the 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis in a cohort of patients presenting with suspected giant cell arteritis. Arthritis Rheumatol. 2023;75(6):1075-1077. doi:10.1002/art.42440
12. Narváez J, Estrada P, Vidal-Montal P, Nolla JM. Performance of the new 2022 ACR/EULAR classification criteria for giant cell arteritis in clinical practice in relation to its clinical phenotypes. Autoimmun Rev. 2023;22(10):103413. doi:10.1016/j.autrev.2023.103413
13. Sanchez-Martin J, Medina-Del Valle J, Loricera J, et al. AB0733 concordance between the 1990 ACR classification criteria and the new 2022 ACR/EULAR 2022 criteria in giant cell arteritis. Annals Rheumatic Dis. 2023;82:p.1572.2-1573. doi:10.1136/annrheumdis-2023-eular.6144
14. Bergner R, Schulz P, Friedrich J. AB0704 evaluation of the of the 2022 ACR/EULAR classification criteria for GCA in a German patient cohort. Scientific abstracts. Annals Rheumatic Dis. 2023;82:1555-1556. doi:10.1136/annrheumdis-2023-eular.2102
15. Andel P, Diamantopoulos A, Myklebust G, Haugeberg G. Vasculitis distribution and clinical characteristics in giant cell arteritis: a retrospective study using the new 2022 ACR/EULAR classification criteria. Front Med (Lausanne). 2023;10:1286601. doi:10.3389/fmed. 2023.1286601
16. Nieuwland M van, Bon L van, Vermeer M, et al. External validation of the 2022 ACR/EULAR classification criteria in patients with suspected giant cell arteritis in a Dutch fast-track clinic. RMD Open. 2023;9(3): e003080. doi:10.1136/rmdopen-2023-003080
17. Sandal Uzun G, Gokoz O, Heper A, et al. AB0756 identification of histopathologic findings of patients with giant cell arteritis: a multicentre study in the era of 2022 ACR/EULAR classifıcation criteria for GCA. Annals Rheumatic Dis. 2023;2(Suppl 1):p.1584.1-1585. doi:10.1136/annrheumdis-2023-eular.1935
1. Dejaco C, Brouwer E, Mason JC, et al. Giant cell arteritis and polymyalgia rheumatica: current challenges and opportunities. Nat Rev Rheumatol. 2017;13(10):578-592. doi:10.1038/nrrheum.2017.142
2. Kermani TA, Schäfer VS, Crowson CS, et al. Increase in age at onset of giant cell arteritis: a population-based study. Ann Rheum Dis. 2010; 69(4):780-781. doi:10.1136/ard.2009.111005
3. Bull Haaversen AC, Brekke LK, Kermani TA, et al. Extended ultrasound examination identifies more large vessel involvement in patients with giant cell arteritis. Rheumatology. 2023;62(5):1887-1894. doi:10.1093/rheumatology/keac478
4. Hunder GG, Bloch DA, Michel BA, et al. The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum. 1990;33(8):1122-1128. doi:10.1002/art.1780330810
5. Seeliger B, Sznajd J, Robson JC, et al. Are the 1990 American College of Rheumatology vasculitis classification criteria still valid? Rheumatology. 2017;56(7):1154-1161. doi:10.1093/rheumatology/kex075
6. Schmidt WA, Dasgupta B, Luqmani R, et al. A Multicentre, randomised, double-blind, placebo-controlled, parallel-group study to evaluate the efficacy and safety of sirukumab in the treatment of giant cell arteritis. Rheumatol Ther. 2020;7(4):793-810. doi:10.1007/s40744-020-00227-2
7. Venhoff N, Schmidt WA, Lamprecht P, et al. Efficacy and safety of secukinumab in patients with giant cell arteritis: study protocol for a randomized, parallel group, double-blind, placebo-controlled phase II trial. Trials. 2021;22(1):543. doi:10.1186/s13063-021-05520-1
8. Ponte C, Grayson PC, Robson JC, et al. 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis. Arthritis Rheumatol. 2022;74(12):1881-1889. doi:10.1002/art.42325
9. Opri?-Belinski D, Cobilinschi CO, Saulescu I. Current perspectives in giant cell arteritis: can we better connect pathogenesis and treatment? Medicina (B Aires). 2024;60(3):400. doi:10.3390/medicina60030400
10. Molina-Collada J, Castrejón I, Monjo I, et al. Performance of the 2022 ACR/EULAR giant cell arteritis classification criteria for diagnosis in patients with suspected giant cell arteritis in routine clinical care. RMD Open. 2023;9(2):e002970. doi:10.1136/rmdopen-2022-002970
11. Hemmig AK, Aschwanden M, Imfeld S, Berger CT, Daikeler T. A diagnostic performance study of the 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis in a cohort of patients presenting with suspected giant cell arteritis. Arthritis Rheumatol. 2023;75(6):1075-1077. doi:10.1002/art.42440
12. Narváez J, Estrada P, Vidal-Montal P, Nolla JM. Performance of the new 2022 ACR/EULAR classification criteria for giant cell arteritis in clinical practice in relation to its clinical phenotypes. Autoimmun Rev. 2023;22(10):103413. doi:10.1016/j.autrev.2023.103413
13. Sanchez-Martin J, Medina-Del Valle J, Loricera J, et al. AB0733 concordance between the 1990 ACR classification criteria and the new 2022 ACR/EULAR 2022 criteria in giant cell arteritis. Annals Rheumatic Dis. 2023;82:p.1572.2-1573. doi:10.1136/annrheumdis-2023-eular.6144
14. Bergner R, Schulz P, Friedrich J. AB0704 evaluation of the of the 2022 ACR/EULAR classification criteria for GCA in a German patient cohort. Scientific abstracts. Annals Rheumatic Dis. 2023;82:1555-1556. doi:10.1136/annrheumdis-2023-eular.2102
15. Andel P, Diamantopoulos A, Myklebust G, Haugeberg G. Vasculitis distribution and clinical characteristics in giant cell arteritis: a retrospective study using the new 2022 ACR/EULAR classification criteria. Front Med (Lausanne). 2023;10:1286601. doi:10.3389/fmed. 2023.1286601
16. Nieuwland M van, Bon L van, Vermeer M, et al. External validation of the 2022 ACR/EULAR classification criteria in patients with suspected giant cell arteritis in a Dutch fast-track clinic. RMD Open. 2023;9(3): e003080. doi:10.1136/rmdopen-2023-003080
17. Sandal Uzun G, Gokoz O, Heper A, et al. AB0756 identification of histopathologic findings of patients with giant cell arteritis: a multicentre study in the era of 2022 ACR/EULAR classifıcation criteria for GCA. Annals Rheumatic Dis. 2023;2(Suppl 1):p.1584.1-1585. doi:10.1136/annrheumdis-2023-eular.1935
Article available in :
Volume 6, Issue 3, 2025
Page : 194-198
https://doi.org/10.47582/jompac.1625308
Article Information
Received : 22 Oca 2025
Accepted : 15 Nis 2025
Published : 18 Haz 2025
Corresponding Author :

Mehmet Nur Kaya: University of Health Sciences, Gülhane Training and Research Hospital, Department of Rheumatology, Ankara, Turkey

[email protected],
Citation : Kaya MN, Tecer D, Kılıç Ö, Yılmaz S. Evaluating the diagnostic accuracy of the 2022 ACR/EULAR classification criteria for giant cell arteritis in routine clinical practice. J Med Palliat Care. 2025;6(3):194-198. doi:10.47582/jompac.1625308

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