ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 899

Disparities in Disease Characteristics, Treatment Pattern and Comorbidities in 1,858 Patients with Polymyalgia Rheumatica, Giant Cell Arteritis or Both Diseases

Dörte Huscher1, Katinka Albrecht1, Frank Buttgereit2, Martin Aringer3, Guido Hoese4, Wolfgang Ochs5, Katja Thiele1 and Angela Zink1,2, 1Epidemiology, German Rheumatism Research Centre, Berlin, Germany, 2Rheumatology and Clinical Immunology, Charité - University Medicine Berlin, Berlin, Germany, 3Medicine III, University Medical Center and Faculty of Medicine at the TU Dresden, Dresden, Germany, 4Rheumatologische Fachpraxis Stadthagen, Stadthagen, Germany, 5Internistisch-rheumatologische Praxisgemeinschaft Bayreuth, Bayreuth, Germany

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: , , ,

Session Information

Date: Sunday, November 13, 2016

Title: Vasculitis - Poster I: Large Vessel Vasculitis and Polymyalgia Rheumatica

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:   To evaluate disease characteristics, treatment patterns and comorbidities in patients with polymyalgia rheumatica (PMR) to those with giant cell arteritis (GCA), or with both diseases (PMR+GCA).

Methods:  Patients enrolled in the national database of the German Collaborative Arthritis Centres between 2007 and 2014 were stratified to PMR, GCA, PMR+GCA. They were compared with regard to patient characteristics, treatment and comorbidities, subdivided by disease duration. Logistic regression analyses were performed to evaluate the risk of having PMR+GCA and the association of this condition with malignant neoplasms. To put the prevalence of malignant neoplasms into perspective, patients of the three groups were matched with patients with rheumatoid arthritis (RA) by age, sex and disease duration.

Results:   Data of 1,858 patients with PMR/ GCA/ PMR+GCA (n=1,420/ n=177/ n=261) were available for analysis. Mean age (73 years in each group) and disease duration (4.2/3.6/4.4 years) were comparable between these groups. Patients with PMR only were less often female (63/74/72%). PMR+GCA patients had the highest mean ESR value (21/23/26 mm/h), and more frequently hypertension (49/54/59%) and malignant neoplasms (7/7/12%). Osteoporosis was most prevalent in GCA (17/26/21%). PMR+GCA patients were most often current smokers, especially at disease onset (10/13/20%, p<0.01). They received the highest mean prednisone dose (5.9/6.1/9.6 mg/d) and had the highest analgesics use (14/24/39%). Multivariate analyses confirmed smoking to be associated with an increased risk of having PMR+GCA (OR=3.6, p<0.001), and identified patients with PMR+GCA to suffer from a higher malignancy risk (OR=2.0, p=0.002). When compared to RA patients, PMR and GCA patients showed a prevalence of malignancies similar to their matched RA counterparts (PMR 6.6% vs. RA 6.7%, 95% CI of the difference [-0.9; 1.2] , n=1,299 pairs, and GCA 6.5% vs. RA 7.6%, 95% CI [-2.0; 4.5], n=155 pairs), while patients with PMR+GCA had a significantly higher prevalence (PMR+GCA 12.3% vs. RA 6.7%, 95% CI [-7.6; -3.4], n=235 pairs). Thereby the frequency of smoking did not differ significantly between the corresponding groups.

Conclusion:   Patients with PMR+GCA had higher inflammatory activity, the highest need of glucocorticoids and a high comorbid burden. The observed associations of PMR+GCA with smoking on the one hand and with malignant neoplasms on the other should be further investigated, since both would significantly affect patient education and GCA management.

Disclosure: D. Huscher, None; K. Albrecht, None; F. Buttgereit, None; M. Aringer, None; G. Hoese, None; W. Ochs, None; K. Thiele, None; A. Zink, None.

To cite this abstract in AMA style:

Huscher D, Albrecht K, Buttgereit F, Aringer M, Hoese G, Ochs W, Thiele K, Zink A. Disparities in Disease Characteristics, Treatment Pattern and Comorbidities in 1,858 Patients with Polymyalgia Rheumatica, Giant Cell Arteritis or Both Diseases [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/disparities-in-disease-characteristics-treatment-pattern-and-comorbidities-in-1858-patients-with-polymyalgia-rheumatica-giant-cell-arteritis-or-both-diseases/. Accessed .

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