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Comparative Study
. 2025 Jan 7;27(1):4.
doi: 10.1186/s13075-024-03468-6.

Mortality in patients with giant cell arteritis in Spain: results from the ARTESER registry

Juan Molina-Collada  1 , Marta Domínguez-Álvaro  2 , Rafael B Melero-González  3 , Eugenio de Miguel  4 , Maite Silva-Díaz  5 , Jesús Alejandro Valero Jaimes  6 , Ismael González  7 , Julio Sánchez Martín  8 , Javier Narváez  9 , Joan Calvet  10 , Ivette Casafont-Solé  11 , Jose A Román Ivorra  12 , Selene Labrada Arrabal  13 , Margarida Vasques Rocha  14 , Carlota L Iñiguez  15 , María Sagrario Bustabad Reyes  16 , Cristina Campos Fernández  17 , María Alcalde Villar  18 , Antonio Juan Mas  19 , Ricardo Blanco  8 ; ARTESER Project Collaborative Group
Collaborators, Affiliations
Comparative Study

Mortality in patients with giant cell arteritis in Spain: results from the ARTESER registry

Juan Molina-Collada et al. Arthritis Res Ther. .

Abstract

Objectives: To compare mortality rates between GCA patients and the general population in Spain, and to identify associated factors influencing mortality.

Methods: ARTESER, a multicenter registry by the Spanish Society of Rheumatology, includes GCA patients from June 2013 to March 2019. Demographic, clinical, imaging, histological and mortality data were collected retrospectively. Only patients with at least one year of follow-up were included for analysis. The mortality rates were expressed as the number of deaths per 1000 person-years, with 95% confidence interval (CI) by sex and age group. Kaplan-Meier method was performed for survival analysis. The factors influencing mortality were analyzed using Cox regression model.

Results: A total of 1200 patients with GCA were analyzed, with a mean (SD) follow-up of 2.18 (1.53) years. The overall five-year cumulative mortality rate (95%CI) was 37.86 (31.75-43.96) per 1000 patients/year. The cumulative mortality rate was significantly higher in males than females (59.04vs29.06; p<0.001). The age- and sex-adjusted cumulative mortality rate was similar to the Spanish general population (19.75vs20.72;p=0.559). In the multivariate analysis, older age (HR 1.11, 95%CI 1.073-1.142) and male sex (HR 1.775, 95%CI 1.214-2.594) were associated with increased mortality. Headache (HR 0.55, 95%CI 0.362-0.843) and high hemoglobin levels (HR 0.85, 95%CI 0.744-0.970) were protective factors against death.

Conclusions: The overall five-year age- and sex-adjusted cumulative mortality rate in GCA is similar compared to the general population. Older age and male sex appear to be associated with an increased risk of mortality, whereas headache and high hemoglobin levels might serve as protective factors against death.

Keywords: Giant cell arteritis; Mortality; Survival; Vasculitis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study protocol was approved by the Ethics Committee for Research with Medicines of Cantabria, Santander, Spain (No. 05/2019). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Competing interests: Juan Molina-Collada has received consultancy/speaker’s fees from AbbVie, Lilly, Janssen, Novartis, Pfizer, UCB, MSD, and BMS. None of these fees were related to the present manuscript. Ricardo Blanco received grants/research support from AbbVie, MSD, and Roche, and had consultation fees/participation in a company-sponsored speaker’s bureau from AbbVie, Pfizer, Roche, Lilly, UCB, Bristol-Myers, Janssen, and MSD. Eugenio de Miguel received research funding/consulting and conferences fees from: Abbvie, Novartis, Roche, Pfizer, Janssen, Lilly, MSD, BMS, UC Pharma, Grünenthal and Sanofi. Carlota L Iñiguez received support and speaker's fees from Pfizer, AbbVie, Fresenius - Kiabi, Novartis, GSK, Sanofi y Janssen.

Figures

Fig. 1
Fig. 1
The five-year cumulative mortality rate in GCA patients and in the general population in Spain (NSI) across different year ranges
Fig. 2
Fig. 2
Kaplan-Meier survival rates in (A) all patients with GCA, (B) distributed by sex and (C) distributed by age, included in the ARTESER registry. The differences in the Kaplan-Meier curves were statistically significant (Log-rank p-value < 0.001)
See this image and copyright information in PMC

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