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Giant cell arteritis tied to increased all-cause mortality shortly after diagnosis

In a large population-based study, patients with giant cell arteritis (GCA) had 51% increased risk for mortality during the first year after diagnosis than patients with non-vasculitis. Mortality risk decreased over time with no risk >5 years since the diagnosis. Mortality risk was even higher in patients diagnosed with GCA at <65 years. These findings were published in the journal Arthritis Care & Research.

Authors used data from the UK-based Clinical Practice Research Datalink to identify 9778 patients with first-time diagnosis of GCA (age, ≥50 years at diagnosis) between January 1990 and December 2014. Each patient with GCA was matched to at least 10 non-vasculitis patients from general population.

Compared to patients with non-vasculitis, patients with GCA had increased mortality in the first year following diagnosis (aHR, 1.51, 95% CI, 1.40-1.64), marginally increased mortality between 1-5 years post-diagnosis (aHR, 1.16; 95% CI, 1.09-1.23), but not >5 years post-diagnosis (aHR, 1.06; 95% CI, 1.00-1.12). Patients diagnosed with GCA at age <65 years had highest mortality risk for the first year following diagnosis (aHR, 2.32; 95% CI, 1.60-3.35).

Authors assume that increased 1-year mortality risk following the diagnosis could be because of active GCA itself, intensive treatment, particularly with glucocorticoids which have several adverse events or comorbidities related to active disease. They further add that reduction in relative effect of GCA with longer follow-up may be because of its remission, decreased intensity of immunosuppressive therapy and the contribution of other non-GCA-related factors.


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