All-cause and cause-specific mortality in patients with giant cell arteritis: a nationwide, population-based cohort study. (23rd June 2021)

• Record Type: Journal Article
• Authors: Therkildsen, Philip; Nielsen, Berit Dalsgaard; de Thurah, Annette; Hansen, Ib Tønder; Nørgaard, Mette; Hauge, Ellen-Margrethe
• Is Part Of: Rheumatology. Volume 61:Number 3(2022)
• Page Start: 1195
• Page End: 1203
• Publication Date: 2021-06-23
• Subjects: giant cell arteritis -- epidemiology -- mortality -- large-vessel vasculitis -- temporal artery biopsy -- nationwide register; Rheumatism -- Periodicals; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1093/rheumatology/keab507
• Languages: English
• ISSNs: 1462-0324

Abstract

Abstract: Objectives: To investigate whether GCA is associated with increased all-cause and cause-specific mortality. Methods: A nationwide, population-based cohort study in Denmark using medical and administrative registries. GCA cases were defined as patients aged ≥50 years from 1996–2018 with a first-time discharge diagnosis of GCA and ≥3 prescriptions for prednisolone within 6 months following diagnosis. Each GCA patient was matched based on age, sex and calendar time to 10 persons without a history of GCA. Index date was the date for the third prednisolone prescription. We used a pseudo-observation approach to calculate all-cause and cause-specific mortality, adjusted risk differences (RDs) and relative risks (RRs). Results: We included 9908 GCA patients and 98 204 persons from the general population. The median time for GCA patients to redeem the third prednisolone prescription was 74 days [interquartile range (IQR: 49–106)]. Among GCA patients, the overall mortality was 6.4% (95% CI: 5.9, 6.9) 1 year after index date and 45% (95% CI: 44, 47) after 10 years. Compared with the reference cohort, adjusted RDs and RRs of deaths in the GCA cohort were 2.2% (95% CI: 1.7, 2.7) and 1.49 (95% CI: 1.36, 1.64) after 1 year, and 2.1% (95% CI: 1.0, 3.3) and 1.03 (95% CI: 1.00, 1.05) 10 years after index date. GCA patients had a higher risk of death due to infectious, endocrine, cardiovascular and gastrointestinal diseases. Conclusions: GCA is associated with increased all-cause mortality, particularly within the first year following the diagnosis. Cause-specific mortality indicates that mortality in GCA may in part be due to glucocorticoid-related complications.