Incidence and General Clinical Features of Giant Cell Arteritis in the ARTESER Multicenter Study

Jesús T. Sánchez-Costa¹, Rafael B. Melero-González², Elisa Fernández-Fernández³, María T. Silva-Diaz⁴, Joaquín M. Belzunegui⁵, Clara Moriano⁶, Julio Sánchez⁷, Judit Lluch⁸, Itziar Calvo⁹, Vicente Aldasoro¹⁰, Lydia Abasolo¹¹, Javier Loricera¹², Alberto Ruíz-Román¹³, Santos Castañeda¹⁴, Patricia Moya¹⁵, María J. Garcia-Villanueva¹⁶, Vanessa A. Navarro-Angeles¹⁷, Carles Galisteo¹⁸, Anne Riveros-Frutos¹⁹, Jose A. Román-Ivorra²⁰, Selene Labrada-Arrabal²¹, Margarida Vasques-Rocha²², Carlota L. Iñiguez-Ubiaga²³, María García-González²⁴, Clara Molina-Almela²⁵, María Alcalde-Villar²⁶, Antonio Juan Mas²⁷, Eugenio De Miguel²⁸, Javier Narvaez²⁹, Miguel Ángel gonzalez-Gay³⁰, Noemí Garrido-Puñal¹³, Paula V. Estrada-Alarcon¹⁷ and Ricardo Blanco³¹, ¹Research unit, Spanish Society of Rheumatology, Madrid, Spain, ²Complejo Hospitalario Universitario de Vigo, Vigo, Spain, ³Rheumatology department, La Paz University Hospital, Madrid, Spain, ⁴Complejo Hospitalario Universitario de La Coruña, Coruña, Spain, ⁵Hospital Universitario Donostia, Donostia-San Sebasti, Spain, ⁶Hospital Universitario de León, León, Spain, ⁷Hospital Universitario 12 de Octubre, Madrid, Spain, ⁸Hospital Universitari Bellvitge, Hospitalet de Llobregat, Spain, ⁹Basurto University Hospital, Bilbao, Spain, ¹⁰Complejo Hospitalario de Navarra, Pamplona, Spain, ¹¹Rheumatology Department, Hospital Clínico San Carlos, Madrid, Spain, ¹²Hospital Universitario Marqués de Valdecilla, Santander, Spain, ¹³Hospital Universitario Virgen del Rocío, Sevilla, Spain, ¹⁴Hospital Universitario de la Princesa, Madrid, Spain, ¹⁵Hospital Sant Pau, Barcelona, Spain, ¹⁶Rheumatology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain, ¹⁷Hospital de Sant Joan Despí Moisès Broggi. Sant Joan Despí, Barcelona, Spain, ¹⁸Hospital Universitari Parc Tauli, Saadell, Spain, ¹⁹Hospital Germans Trias i Pujol, Badalona, Spain, ²⁰Hospital Universitari i Politècnic La Fe, Valencia, Spain, ²¹Hospital del Mar, Barcelona, Spain, ²²Hospital Universitario Araba, Vitoria-Gasteiz, Spain, ²³Hospital Universitario Lucus Augusti, Lugo, Spain, ²⁴Hospital Universitario de Canarias, La Laguna, Spain, ²⁵Rheumatology Department, Consorci Hospital General Universitari de Valencia, Valencia, Spain, ²⁶Hospital Universitario Severo Ochoa, Leganés, Spain, ²⁷Rheumatology Department, Hospital Universitario Son Llàtzer, Palma de Mallorca, Spain, ²⁸Hospital Universitario La Paz, Madrid, Spain, ²⁹Division of Rheumatology, Hospital Universitario de Bellvitge, Barcelona, Spain, ³⁰Research group on Genetic Epidemiology and Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the Musculoskeletal System, IDIVAL, Division of Rheumatology, Hospital Universitario Marqués de Valdecilla; School of Medicine, Universidad de Cantabria, Santander, Spain. Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa, ³¹Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain

Meeting: ACR Convergence 2021

Keywords: autoimmune diseases, Epidemiology, giant cell arteritis, longitudinal studies, Vasculitis

Session Information

Date: Monday, November 8, 2021

Session Title: Vasculitis – Non-ANCA-Associated & Related Disorders Poster I: Giant Cell Arteritis & Polymyalgia Rheumatica (1391–1419)

Session Type: Poster Session C

Session Time: 8:30AM-10:30AM

Background/Purpose: Epidemiological information on Giant Cell Arteritis (GCA) comes mainly from the Scandinavian countries of northern Europe, which show a higher incidence than the countries of southern Europe. GCA clinical manifestations can be divided into cranial, extracranial, and general syndrome.

In a large series of GCA from Spain, we studied a) the incidence of GCA, b) clinical manifestations, and c) comorbidities at the time of disease diagnosis.

Methods: ARTESER is a retrospective epidemiological observational study of GCA promoted by the Spanish Society of Rheumatology in which 26 hospitals participate. The inclusion criteria were: all new patients diagnosed with GCA by a) ACR criteria, b) positive diagnostic test (temporal artery biopsy, temporal artery ultrasound or other relevant imaging techniques) and/or c) investigator’s clinical judgment. The patient recruitment period ranged from June 1, 2013 to March 29, 2019. The overall incidence of GCA per 100,000 people ≥50 years for the whole period and the mean annual incidence were evaluated. The clinical variables were collected by reviewing the patient’s medical history.

Results: 1675 patients were included. The average annual incidence rate was 7.42 (95% CI: 6.57-8.27). All the cases were older than 50 years, and the age group with the highest incidence was that of 80 to 84 years, where it reached a value of 130.12 (95% CI: 126.71-133.54). The mean annual incidence is higher in women than in men 10.06 (95% CI: 8.7-11.5) vs 4.83 (95% CI 3.8- 5.9) (Table 1).

The description of the population is shown in Table 2, the mean age at diagnosis was 76.9±8.1 years, 1178 (70.3%) were women. ACR criteria were met by 1400 (83.6%) patients and an objective diagnostic test by 1258 (75.1%). The more frequent comorbidity was arterial hypertension (n=1079; 64.6%), followed by dyslipidemia (n=801, 48%). The predominant cranial manifestation was headache, (n= 1337; 79.9%) and 605 patients experienced visual symptoms (36.1%). Polymyalgia rheumatica (n=699; 41.8%) and asthenia (n=837; 52.2%) were the most frequent extracranial and general syndrome manifestation, respectively. Regarding laboratory parameters, the most characteristic data was the increase of ESR (75.9±33.6 mm/1^st h).

Conclusion: The mean annual incidence of GCA in Spain, 7.42 (95% CI: 6.57-8.27), is lower than that of the Scandinavian countries. It is higher in people older than 80 years. Cranial manifestations constituted the most clinical features. The most frequent clinical manifestations are cranial. Up to a third of patients had visual manifestations.

Table 1. Incidence rate by age groups and sex from June 2013 to March 2019 (x 100,000 inhabitants ≥50 years)

Table 2. General characteristics, comorbidities and clinical manifestations

Disclosures: J. Sánchez-Costa, None; R. Melero-González, None; E. Fernández-Fernández, None; M. Silva-Diaz, None; J. Belzunegui, None; C. Moriano, None; J. Sánchez, None; J. Lluch, None; I. Calvo, None; V. Aldasoro, None; L. Abasolo, None; J. Loricera, None; A. Ruíz-Román, None; S. Castañeda, None; P. Moya, None; M. Garcia-Villanueva, None; V. Navarro-Angeles, None; C. Galisteo, None; A. Riveros-Frutos, None; J. Román-Ivorra, None; S. Labrada-Arrabal, None; M. Vasques-Rocha, None; C. Iñiguez-Ubiaga, None; M. García-González, None; C. Molina-Almela, None; M. Alcalde-Villar, Nordic, 12, Tutor of rheumatology trainee at regional congress; A. Juan Mas, None; E. De Miguel, Roche, 6, 12, Paid instructor, Abbvie, 2, 5, 6, Novartis, 2, 5, 6, 12, Paid instructor, Pfizer, 2, 5, 6, MSD, 6, BMS, 6, UCB, 6, Grunental, 6, Janssen, 6, 12, Paid instructor, Sanofi, 6, Galapagos, 2; J. Narvaez, None; M. gonzalez-Gay, None; N. Garrido-Puñal, None; P. Estrada-Alarcon, None; R. Blanco, Brystol Myers Squibb, 6.

To cite this abstract in AMA style:

Sánchez-Costa J, Melero-González R, Fernández-Fernández E, Silva-Diaz M, Belzunegui J, Moriano C, Sánchez J, Lluch J, Calvo I, Aldasoro V, Abasolo L, Loricera J, Ruíz-Román A, Castañeda S, Moya P, Garcia-Villanueva M, Navarro-Angeles V, Galisteo C, Riveros-Frutos A, Román-Ivorra J, Labrada-Arrabal S, Vasques-Rocha M, Iñiguez-Ubiaga C, García-González M, Molina-Almela C, Alcalde-Villar M, Juan Mas A, De Miguel E, Narvaez J, gonzalez-Gay M, Garrido-Puñal N, Estrada-Alarcon P, Blanco R. Incidence and General Clinical Features of Giant Cell Arteritis in the ARTESER Multicenter Study [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/incidence-and-general-clinical-features-of-giant-cell-arteritis-in-the-arteser-multicenter-study/. Accessed January 30, 2023.

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