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    Geo-epidemiology of temporal artery biopsy-positive giant cell arteritis in Australia and New Zealand: is there a seasonal influence?

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    Author
    De Smit, E; Clarke, L; Sanfilippo, PG; Merriman, TR; Brown, MA; Hill, CL; Hewitt, AW
    Date
    2017-10-01
    Source Title
    RMD Open
    Publisher
    BMJ PUBLISHING GROUP
    University of Melbourne Author/s
    Clarke, Linda; DE SMIT, ELISABETH; Sanfilippo, Paul
    Affiliation
    Centre for Eye Research Australia (CERA)
    Ophthalmology (Eye & Ear Hospital)
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    De Smit, E., Clarke, L., Sanfilippo, P. G., Merriman, T. R., Brown, M. A., Hill, C. L. & Hewitt, A. W. (2017). Geo-epidemiology of temporal artery biopsy-positive giant cell arteritis in Australia and New Zealand: is there a seasonal influence?. RMD OPEN, 3 (2), https://doi.org/10.1136/rmdopen-2017-000531.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/255449
    DOI
    10.1136/rmdopen-2017-000531
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5706482
    Abstract
    Objective: Previous studies, although inconclusive, have suggested possible associations of environmental risk factors with the development of giant cell arteritis (GCA). We aim to investigate seasonal influence on the incidence of GCA across Australia and New Zealand. Methods: In establishing an international study to investigate the molecular aetiology of GCA, archived temporal artery biopsy (TAB) specimens primarily from Australia and New Zealand were obtained. Demographic details including age, sex and date of TAB were collected from collaborating pathology departments. The season in which GCA was diagnosed was determined and compared with previous reports investigating the association between environmental risk factors and GCA. Results: Our study comprises data from 2224 TAB-positive patients with GCA; 2099 of which were from patients in Australia and New Zealand. The mean age at time of diagnosis was 76.4 years of age. The female-to-male ratio was 2.2:1. We noted equal distribution of the incidence rate across all four seasons (530-580 cases diagnosed every quarter). Statistical analysis of seasonal variation by Poisson regression and cosinor methods showed no incidence preponderance across seasons. Our results do not support a seasonal component contributing to the onset of disease. Our literature search identifies no consistent environmental risk factor in association with GCA. Conclusion: This is the largest GCA data set reported outside of Europe. Our results demonstrate equal distribution of the incidence rate across all four seasons. In contrast to some earlier reports, we did not identify evidence of a seasonal component contributing to the onset of disease.

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