OP0144 MORTALITY IN GIANT-CELL ARTERITIS PATIENTS: A NATIONWIDE POPULATION-BASED STUDY

Abstract

Background Giant cell arteritis (GCA), is the most common type of chronic systemic vasculitis over the age of 50. So far, studies regarding mortality in giant-cell arteritis (GCA) patients had yielded conflicting results. Objectives In this large population-based study we aimed to examine whether GCA is associated with increased mortality in different time periods, and in patients diagnosed ≤ 70 years of age. Methods We utilized the medical database of the Clalit-Health-Services in a retrospective cohort study. Follow-up was from January 1st, 2002 and continued until death or end of study follow-up at September 1st, 2018. Incident GCA patients were compared with age- and sex-matched controls. Estimated median survival-times were calculated using Kaplan-Meyer (KM) method and Risk for all-cause mortality in different follow-up periods was obtained by Cox proportional-hazard model, adjusted for age, gender, socio-demographic variables and traditional risk factors. Results Our study included 7,294 GCA patients and 34,156 age- and sex-matched controls. The mean age at the start of follow-up was 72.11±9.90 years with 69.2% females. The crude mortality rates for the entire follow-up period was 33.4% amongst GCA patients and 30.2% amongst controls. In KM analysis estimated median survival-time was 13.08 years (95% CI, 12.64-13.52 years) in GCA patients compared to 14.35 years (95% CI, 14.09-14.61) in controls (P-value 10 years after diagnosis (HR 1.13; 95% CI 1.02-1.32). Risk was higher in patients diagnosed ≤70 years of age [HR 1.66 (95% CI 1.22-2.13) 0-2 years; HR 1.44 (95% CI 1.16-1.79) > 10 years]. Conclusion GCA patients have a minor decrease in long-term survival compared to age-and-sex matched controls. The seen difference is due to excess mortality in the first 2 years, and >10 years after diagnosis of GCA, especially in patients diagnosed ≤70 years of age.