ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2669

Survival Trends in Giant Cell Arteritis: A Population-based Cohort Study

Thomas Garvey1, Cynthia Crowson 1, Matthew Koster 2, Eric Matteson 3 and Kenneth Warrington 2, 1Mayo Clinic Rochester, Rochester, 2Mayo Clinic Rochester, Rochester, MN, 3Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA, Rochester

Meeting: ACR/ARP Annual Meeting 2019

Keywords: ,

Session Information

Date: Tuesday, November 12, 2019

Title: Vasculitis – Non-ANCA-Associated & Related Disorders Poster III: Giant Cell Arteritis

Session Type: Poster Session (Tuesday)

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

Background/Purpose: To investigate survival trends in patients with giant cell arteritis (GCA) diagnosed over a 60-year period.

Methods: We assembled a population-based incidence cohort of patients with GCA diagnosed between 1950 and 2009 based on American College of Rheumatology 1990 GCA classification criteria. Patients aged ≥ 50 years with elevation of erythrocyte sedimentation rate or C-reactive protein and radiographic evidence of large vessel vasculitis attributed to GCA were also included. Patients were followed until death, last contact, or December 31, 2018. Survival trends were analyzed by grouping patients according to year of GCA diagnosis into the following categories: Group A (years of diagnosis (1950-1979), Group B (1980-1989), Group C (1990-1999) and Group D (2000-2009). Mortality rates were estimated using the Kaplan-Meier method and were compared with expected mortality rates for persons of the same age, sex, and calendar year estimated using Minnesota population life tables.

Results: The study population included 245 incident cases of GCA; 194 (79%) women and 51 (21%) men, with mean age (±SD) 76.2 ± 8.3 years and median follow-up 10.6 years.  Based on comparison to Minnesota lifetables, there was no overall difference in survival when comparing the GCA cohort to the general population.  The 2, 5 and 10 year survival rates (95% CI) were 89% (86, 93), 76% (70, 81) and 56% (50, 63) respectively with a standardized mortality ratio of 0.99 (0.86, 1.14).  The standardized mortality ratios for Groups A, B, C and D were 0.83 (0.57, 1.17) p=0.30; 0.92 (0.63, 1.3) p=0.63; 1.21 (0.85, 1.69) p=0.25 and 0.70 (0.50, 0.95) p=0.02, respectively. 

Conclusion: In this population based-cohort of patients with GCA diagnosed over a 60-year period, the survival of patients diagnosed in recent years was significantly better than that of the general population.  The explanation for this novel finding is unclear, but likely to be multifactorial. Improved treatment of co-morbidities, mitigation of glucocorticoid toxicity such as osteoporosis, and improved management of aortic complications may be contributing to improved survival in GCA.

Figure 1. Age and sex adjusted comparison of survival of Olmsted County residents with incident GCA by time period.

Figure 2. Survival of Olmsted county residents with incident GCA in 1950-2009 compared to expected rates from Minnesota lifetables -observed: solid line; expected dashed line- by time period -A: 1950-79, B: 1980-89, C: 1990-99, D: 2000-09-.

Disclosure: T. Garvey, None; C. Crowson, Crescendo Bioscience, 5, Crescendo BioScience Inc., 5, Crescendo Bioscience Inc., 5, Crescendo Biosciences inc., 5, Pfizer, 2; M. Koster, None; E. Matteson, Boehringer Ingelheim, 5, Pfizer, 2, Sun Pharmaceuticals, 2; K. Warrington, Eli Lilly, 2, GlaxoSmithKline, 2, roche, 2, 8, Roche, 2, 5, 8, Sanofi, 5, sanofi, 5.

To cite this abstract in AMA style:

Garvey T, Crowson C, Koster M, Matteson E, Warrington K. Survival Trends in Giant Cell Arteritis: A Population-based Cohort Study [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/survival-trends-in-giant-cell-arteritis-a-population-based-cohort-study/. Accessed .

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