Giant Cell Arteritis in the Middle East: A Comprehensive Systematic Review and Meta-Analysis of Prevalence, Ocular Manifestations, and Systemic Involvement

Abstract We aimed to review the evidence on epidemiology and manifestations of giant cell arteritis (GCA) in the Middle East. This systematic review adhered to the meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines, and the study protocol was registered in PROSPERO (ID: CRD42024556466). A comprehensive search across three databases (MEDLINE, Cochrane, and EMBASE) was performed from inception to May 2024. Ten articles with 952 GCA patients met our criteria and were included in this review. The mean age ranged from 66 to 75 years, and the male-to-female ratio was 1:1.4 overall. A positive biopsy result was present in 92.31% of the cases. Ocular manifestation occurred in 58.2% of patients. Headache was the most common symptom and occurred in 89.2%. The incidence was estimated at 6.92 per 100,000 observations, and the prevalence was reported between 6.78 and 6.85 per 100,000. Our results show a lower incidence of GCA in the Middle East in contrast to Western populations. Although GCA in the Middle East has similar demographics to cases worldwide, a less gender predominance and more frequent systematic symptoms suggest an influence of regional factors. However, since only four countries in the Middle East were included in this study, we recommend that future research be conducted in underrepresented countries to provide a more comprehensive and accurate analysis.