Mortality in Patients with Giant Cell Arteritis in Spain: Results from the ARTESER Registry

Juan Molina-Collada¹, Marta Domínguez-Álvaro², Rafael Benito Melero-Gonzalez³, Eugenio De Miguel⁴, Maite Silva-Diaz⁵, Jesús Alejandro Valero⁶, Ismael Gonzalez⁷, Julio Sánchez-Martín⁸, Javier Narvaez-García⁹, Joan Calvet¹⁰, Ivette Casafont-Solé¹¹, José A Román Ivorra¹², Selene Labrada-Arrabal¹³, Margarida Vasques Rocha:¹⁴, Carlota L Iñiguez:¹⁵, Maria Sagrario Bustabad Reyes¹⁶, Cristina Campos-Fernández¹⁷, María Alcalde Villar:¹⁸, Antonio Juan-Mas¹⁹ and Ricardo Blanco-Alonso²⁰, and ARTESER Project Collaborative Group, ¹Hospital General Universitario Gregorio Marañón, Madrid, Spain, ²Sociedad Española de Reumatología, Madrid, Spain, ³CHU Ourense, O Carballino, Spain, ⁴Hospital Universitario La Paz, Madrid, Spain, ⁵Complejo Hospitalario Universitario A Coruña, A Coruña, Spain, ⁶Hospital Universitario Donosti. Donostia, Spain, Donosti, Spain, ⁷Complejo Asistencial Universitario de Leon, León, Spain, ⁸Hospital Universitario 12 de Octubre, Madrid, Spain, ⁹Hospital Universitario de Bellvitge, Barcelona, Spain, ¹⁰Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA) (UAB), 08208 Sabadell, Spain, Barcelona, Spain, ¹¹Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain, Barcelona, Spain, ¹²Hospital Universitari i Politècnic La Fe, Valencia, Spain, Valencia, Spain, ¹³Hospital del Mar, Barcelona, Spain, ¹⁴Hospital Universitario Araba, Vitoria, Spain, ¹⁵Hospital Universitario Lucus Augusti, Galicia, Spain, Galicia, Spain, ¹⁶Hospital Universitario de Canarias, La Laguna - Tenerife, Spain, ¹⁷Consorci Hospital General Universitari de València, Comunitat Valenciana, Spain, Valencia, Spain, ¹⁸Hospital Universitario Severo Ochoa Leganés, Madrid, Spain, Madrid, Spain, ¹⁹Hospital Universitari Son Llàtzer, Mallorca, Spain, ²⁰Division of Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Immunopathology group, Santander, Spain

Meeting: ACR Convergence 2024

Keywords: giant cell arteritis, Mortality, risk assessment, Vasculitis

Session Information

Date: Sunday, November 17, 2024

Title: Vasculitis – Non-ANCA-Associated & Related Disorders Poster II

Session Type: Poster Session B

Session Time: 10:30AM-12:30PM

Background/Purpose: The question of survival in epidemiologic studies on giant cell arteritis (GCA) remains unclear to date, with notable heterogeneity in both the mortality rate and distinct patterns of cause-specific death. Our objective is to compare mortality rates between GCA patients and the general population in Spain, and to identify associated factors influencing mortality.

Methods: ARTESER, a multicenter registry by the Spanish Society of Rheumatology, includes GCA patients from June 2013 to March 2019. Demographic, clinical, imaging, histological and mortality data were collected retrospectively. Only patients with at least one year of follow-up were included for analysis. The mortality rates were expressed as the number of deaths per 1000 person-years, with 95% confidence interval (CI) by sex and age group. Kaplan-Meier method was performed for survival analysis. The factors influencing mortality were analyzed using Cox regression model.

Results: A total of 1200 patients with GCA were analyzed (mean age 76.58 years, 30.42% male, with a mean follow-up of 2.18 years). The overall five-year cumulative mortality rate (95%CI) was 37.86 (31.75-43.96) per 1000 patients/year. The cumulative mortality rate was significantly higher in males than females (59.04 vs 29.06;p< 0.001). The age- and sex-adjusted cumulative mortality rate was similar to the Spanish general population (19.75 vs 20.72;p=0.559) (Table 1). In the multivariate analysis, older age (HR 1.11, 95%CI 1.073-1.142) and male sex (HR 1.775, 95%CI 1.214-2.594) were associated with increased mortality. Headache (HR 0.55, 95%CI 0.362-0.843) and high hemoglobin levels (HR 0.85, 95%CI 0.744-0.970) were protective factors against death (Table 2).

Conclusion: The overall five-year age- and sex-adjusted cumulative mortality rate in GCA is similar compared to the general population. Older age and male sex are associated with an increased risk of mortality, whereas headache and high hemoglobin levels are protective factors against death.

Table 1. Five-year mortality rates (95% CI) in GCA patients and the general population in Spain (National Statistics Institute), stratified by age and sex. * Population at 5 years (2013_2019) **Comparison of the five-year cumulative mortality rate in ARTESER and the five-year cumulative mortality rate of the general population (National Statistics Institute); GCA: giant cell arteritis; NSI: National Statistics Institute.

Table 2. Multivariable analysis of factors associated with mortality in patients with GCA. HR: Hazard ratio, * p<0.05

Disclosures: J. Molina-Collada: None; M. Domínguez-Álvaro: None; R. Melero-Gonzalez: None; E. De Miguel: AbbVie/Abbott, 5, 6, BMS, 5, 6, Eli Lilly, 5, 6, Grunental, 5, 6, Janssen, 5, 6, Merck/MSD, 5, 6, Novartis, 5, 6, Pfizer, 5, 6, Roche, 5, 6, sanofi, 5, 6, UCB, 5, 6; M. Silva-Diaz: None; J. Valero: None; I. Gonzalez: None; J. Sánchez-Martín: None; J. Narvaez-García: None; J. Calvet: None; I. Casafont-Solé: None; J. Román Ivorra: None; S. Labrada-Arrabal: None; M. Vasques Rocha:: None; C. L Iñiguez:: None; M. Bustabad Reyes: None; C. Campos-Fernández: None; M. Alcalde Villar:: None; A. Juan-Mas: None; R. Blanco-Alonso: AbbVie, 2, 5, 6, Bristol-Myers Squibb, 2, 6, Galapagos, 6, Janssen, 2, 6, Lilly, 2, 6, MSD, 2, 5, 6, Pfizer, 2, 6, Roche, 2, 5, 6.

To cite this abstract in AMA style:

Molina-Collada J, Domínguez-Álvaro M, Melero-Gonzalez R, De Miguel E, Silva-Diaz M, Valero J, Gonzalez I, Sánchez-Martín J, Narvaez-García J, Calvet J, Casafont-Solé I, Román Ivorra J, Labrada-Arrabal S, Vasques Rocha: M, L Iñiguez: C, Bustabad Reyes M, Campos-Fernández C, Alcalde Villar: M, Juan-Mas A, Blanco-Alonso R. Mortality in Patients with Giant Cell Arteritis in Spain: Results from the ARTESER Registry [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/mortality-in-patients-with-giant-cell-arteritis-in-spain-results-from-the-arteser-registry/. Accessed .

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