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Published on: February 8, 2019
Giant cell arteritis in the elderly
Abrar-Ahmad Zulfiqar1, Marine Richard2, Carl Arndt3
1Département de médecine interne, diabète et maladies métaboliques, Clinique médicale B, Hôpitaux universitaires de Strasbourg, Strasbourg, France
Insights
Giant cell arteritis (GCA) outcomes show no significant differences between patients aged 75 or younger and those older than 75. However, aortitis was less prevalent in older patients, who also had shorter follow-up periods.
Area of Science:
- Rheumatology
- Vascular Medicine
- Geriatric Medicine
Context:
- Giant cell arteritis (GCA), also known as Horton’s disease, is an inflammatory condition affecting large and medium-sized arteries.
- It predominantly affects individuals aged 50 and older, with a peak incidence between 70 and 80 years.
- Limited clinical data exists for GCA patients over 80 years old.
Purpose:
- To evaluate and compare the impact of age on the diagnosis, treatment, and prognosis of GCA.
- To analyze differences in GCA presentation and outcomes between patients aged 75 or younger and those older than 75.
Summary:
- A retrospective study of 67 GCA patients (2012-2017) divided them into two age groups: ≤75 and >75 years.
- No statistically significant differences in mortality or overall outcomes were observed between the age groups.
- Aortitis was less common in patients over 75, while those 75 or younger experienced more relapses, potentially due to shorter follow-up.
Impact:
- This study provides insights into GCA management in elderly populations.
- Findings suggest age itself may not be a critical prognostic factor, but specific manifestations like aortitis may differ.
- Highlights the need for tailored follow-up strategies considering potential differences in disease presentation and relapse rates.
Introduction:
Giant cell arteritis (GCA) or Horton’s disease is a segmental and focal inflammation of large and medium-sized arteries mostly seen in patients of 50 years and older. There is also a peak frequency in individuals between the ages of 70 and 80. However, clinical data is scarce in this age group and especially in patients over 80.
Methods:
A retrospective study comprised of patients diagnosed with Horton’s arteritis between 2012 and 2017, according to the American Society of Rheumatology, was conducted at Reims University Hospital. Patients were assigned to two groups according to age (≤ 75 and < 75) in order to evaluate and compare the impact of age on diagnosis, treatment and prognosis.
Results:
A total of 67 patients were studied. The mean age upon diagnosis was 75,85 ±8.5 years; 36 patients (53.7%) 75 years or younger and 31 patients older than 75. There was a female predominance (43 patients), 22 patients aged 75 years or younger and 21 older than 75. The mean follow up duration was 43.02 months in patients aged 75 years or younger and 30.99 in patients older than 75. This represents a difference of more than one year in terms of follow up, but is not statistically significant (p = 0.620). Eleven patients (16.4%) died during follow up: 5 patients (13.9%) aged 75 years or younger and 6 patients (19.4%) older than 75 (p = 0.547). Aortitis was significantly less seen in patients older than 75 (p = 0.0410).
Conclusion:
Our study showed no significant difference in either age group. However, aortitis was less seen in patients older than 75 years. Patients aged 75 or younger seemed more prone to relapses, but their follow up periods were shorter.
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