Mortality among Patients with Giant Cell Arteritis: A Large-scale Population-based Cohort Study

Area of Science:

• Rheumatology
• Epidemiology
• Gerontology

Background:

• Conflicting results exist regarding mortality in giant cell arteritis (GCA).
• Large population-based studies are needed to clarify GCA's impact on survival.
• Understanding age and sex influences on GCA mortality is crucial.

Purpose of the Study:

• To investigate the association between GCA and all-cause mortality.
• To determine if age at diagnosis and sex modify the mortality risk in GCA patients.

Main Methods:

• Retrospective cohort study using a large health services database.
• Inclusion of 7294 GCA patients and 33,688 age- and sex-matched controls.
• Kaplan-Meier survival analysis and Cox proportional hazard models adjusted for confounders.

Main Results:

• GCA patients had a significantly lower median survival time (13.1 years) compared to controls (14.4 years).
• Increased mortality risk was observed within 2 years (HR 1.14) and over 10 years (HR 1.14) post-diagnosis.
• Patients diagnosed at or before age 70 faced higher mortality risks at both intervals.

Conclusions:

• Giant cell arteritis is associated with a minor decrease in long-term survival.
• Excess mortality in GCA patients occurs in distinct early and late periods after diagnosis.
• Younger age at diagnosis (≤70 years) represents a significant risk factor for increased mortality in GCA.