Issue: April 2021
Perspective from Joni Fontenot, RN
Disclosures: The researchers report no relevant financial disclosures.
March 01, 2021
2 min read
Save

Mortality rising for giant cell arteritis despite declines in general population

Issue: April 2021
Perspective from Joni Fontenot, RN
Disclosures: The researchers report no relevant financial disclosures.
You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

The mortality rate of patients with giant cell arteritis increased from 50 deaths per 1,000 in 2000 to 57.6 per 1,000 in 2018, while mortality among the general population declined, according to data published in Arthritis Care & Research.

“Despite GCA and its treatment being associated with complications known to increase the risk of death, prior research on mortality among individuals with GCA has produced conflicting reports,” Lillian Barra, MD, FRCPC, MPH, of Western University, Schulich School of Medicine & Dentistry, in London, Ontario, and colleagues wrote. “A recent meta-analysis reported an increased risk of mortality in studies of GCA patients in hospitalized settings, but conflicting reports for population-based studies.”

Hospital corridor
The mortality rate of patients with GCA increased from 50 deaths per 1,000 in 2000 to 57.6 per 1,000 in 2018, while mortality among the general population declined, according to data.
Source: Adobe Stock

“The population studies in this meta-analysis included diverse methodologies, with studies often confined to inception cohorts of various follow-up, and variable use of general population comparators,” they added. “Moreover, some studies involving more contemporary cohorts have detected increased mortality risk in GCA, and conflicting reports on sex-related differences in mortality.”

To analyze all-cause mortality among patients with GCA compared with the general population over time, Barra and colleagues conducted a population-based study using health administrative data in Ontario, Canada. Using a validated case definition — with an 81% positive predictive value and 100% specificity — the researchers identified a cohort of 22,677 patients with GCA, aged 50 years or older, during the study period between April 1, 2000, and March 31, 2019. For the comparator group, the researchers used residents in the general population aged 50 years or older without GCA.

Barra and colleagues examined deaths using vital statistics, with annual crude, age/sex‐standardized and age‐ and sex‐specific all‐cause mortality rates determined for those with and without GCA between 2000 and 2018. The researchers also estimated standardized mortality ratios (SMRs).

According to the researchers, age‐ and sex‐standardized mortality rates were significantly higher for patients with GCA compared with the general population and demonstrated an increasing trend over time. Specifically, the mortality rate among patients with GCA increased from 50 (95% CI, 34-71.1) deaths per 1,000 in 2000 to 57.6 (95% CI, 50.8-65.2) deaths per 1,000 in 2018. Meanwhile, mortality rates among the general population significantly declined during this time.

Annual SMRs for patients with GCA generally increased over time, with the lowest ratio occurring in 2002 (1.22; 95% CI, 1.03-1.4) and the highest in 2018 (1.92; 95% CI, 1.81-2.03). Additionally, GCA mortality rates were more elevated for men compared with women.

“In this large population-based study, we found that GCA patients had a significantly higher annual risk of mortality compared to the general population over the 19-year study period,” Barra and colleagues wrote. “The increased mortality risk for GCA patients was seen in males and females and was most pronounced in individuals aged 50 to 65 years of age. Although mortality rates decreased over time for the general population, they trended upwards for GCA patents, resulting in higher SMRs for GCA patients in recent years.”