Survival of patients with giant cell arteritis: a controversial issue

Epidemiologic studies differ regarding overall survival in giant cell arteritis (GCA). In this review we evaluated longevity and the impact of several disease parameters on survival of GCA patients.

Review of the medical literature during the period 1975-2018, using PubMed database.

Epidemiologic studies addressing the issue of survival in GCA patients used variable methods of calculating mortality rates in relation to background population or in relation to selected controls. Several epidemiologic studies found that survival of GCA patients was similar to that of the general population. Others reported increased mortality in patients with GCA, or in subgroups of GCA patients. 5-Year and 10-year survival rates differed considerably among studies: 5-year survival rates ranged between 60-90% (except for 2 extremes of 35% and 97%), and 10-year survival rates ranged between 48-81%. Reasons for these discrepancies are unclear, and may be related to differences in populations, in the period of the study, and in study methods. Several studies found that mortality was increased in female GCA patients, and some reported increased mortality early in the course of the disease (mostly within the first 2 years after diagnosis). The deleterious effect of vision loss on survival was noted in a few studies, although most studies did not address the issue of mortality in this particular subgroup of GCA patients.

Epidemiologic studies varied considerably in the reported outcomes of GCA patients: some found that the overall survival was similar to that of the general population while others reported increased mortality in GCA or in subgroups of GCA patients.