Session Title: Vasculitis
Session Type: Abstract Submissions (ACR)
Background/Purpose: To investigate the incidence, prevalence and mortality of biopsy proven giant cell arteritis (GCA) over a 27-year period in a defined area of northern Italy.
Methods: All patients with incident GCA diagnosed from January 1, 1986 to December 31, 2012 living in the Reggio Emilia area were identified through computerized hospital discharge diagnosis and a structured review of all histopahology reports. Patients were followed up from the time of diagnosis until either their death or December 31, 2012.
Results: Two hundred and eighty-five patients (75 men and 210 women) had biopsy proven GCA according to the histopathological examination. Mean+SD age at diagnosis was 74.4+7.3 years. The mean annual incidence rate (IR) of GCA was 58.16/106 (95% CI: 51.4-64.9). The mean IR was 31.1/106 (95% CI: 26.9-35.4) among women and 11.6/106 (95% CI: 8.9-14.2) for men (p < 0.05). The estimated incidence for people over 50 y was 78.11 (95% CI: 67.4-88.7) for women and 33.4 (95% CI: 25.7-41) for men. The lowest IR occurred in male patients in the 50-59 years age group (5.13/106; 95% CI: 1.4-13.1), the highest IR was observed in female patients 80-84 years age group (215.4/106; 95% CI: 184.7-297.2). IR difference between sex was significant only in the 60-69 age group (IR male/female 14.6/67.1, 95% CI 7.0-26.9 vs 49.8-88.4). The average annual IR increased from 5.63/106 during 1986-1988 to 45.23/106 during 1998-2000 period and was stable thereafter with IR of 30-23/106. Point prevalence on December 31st 2012 was 304.5/106 (95% CI: 258.0-355.7) (women 453.1, 95% CI: 376-541.4, men 148.8, 95% CI: 105.3-204.2).
At histological examination 13.6% (39 pts) had only small vessels perivascular involvement (adventitial vasa vasorum and peri-adventitial capillaries). Prevalence of small vessels involvement was significant higher among male patients (male 30% vs 7%female, p< 0.001). One hundred and twenty-nine patients (45.2%) died during the follow-up period (median survival after diagnosis 152 months [range 4-320 months]). Survival did not differ nor between gender or between different histopathological pattern
Conclusion: This population-based study is the first to report the incidence of biopsy proven GCA in Italy. Our average annual IR is similar to that reported in the period 1984-1988 in Finland (1).
References 1)Franzén P, Sutinen S, von Knorring J. Giant cell arteritis and polymyalgia rheumatica in a region of Finland: an epidemiologic, clinical and pathologic study, 1984-1988. J Rheumatol. 1992; 19:273-6.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/incidence-prevalence-and-survival-of-biopsy-proven-giant-cell-arteritis-in-northern-italy/