POS0693 MORTALITY RATE IN PATIENTS WITH GIANT CELL ARTERITIS IN SPAIN: CAUSES AND ASSOCIATED FACTORS FROM THE ARTESER REGISTRY (2024)

Abstract

Background: The outcomes of epidemiologic studies on giant cell arteritis (GCA) patients display notable heterogeneity regarding the mortality rate and distinct patterns of cause-specific death, underscoring the need for further investigation and a more comprehensive understanding of these critical aspects.

Objectives: To analyze the mortality rate in patients with GCA in Spain and determine the causes of death and associated mortality factors.

Methods: ARTESER is a large Spanish multicenter registry promoted by the Spanish Society of Rheumatology, including patients with GCA diagnosis from June 2013 to March 2019. The following variables were collected at diagnosis and during follow-up per protocol: demographics, presenting symptoms, laboratory test results, temporal artery biopsy and imaging techniques (ultrasound, PET, MRI, CT), death and cause of death. For the purpose of this study, only patients who completed the follow-up visits were included in the analysis. Kaplan-Meier and Cox regression were performed for survival analysis. The factors associated with mortality were analyzed in both univariable and multivariable analyses.

Results: A total of 1200 patients with GCA from the ARTESER registry were analyzed, with mean (SD) follow-up of 2.18 (1.53) years. 142 deaths were recorded during the follow-up assessments. The overall mortality rate (95% CI) was 11.83 (10.00 – 13.66) per 100 patients, being 17.81 (13.86 – 21.75) in males and 11.83 (7.26 – 11.19) in females. Figure 1 shows the Kaplan-Meier survival rate during follow-up. The most common causes of death were infections (31%), malignancies (16%) and cardiovascular diseases (11.3%). In the multivariate analysis (Table 1), older age was the only clinical variable associated with increased mortality (HR 1.11, 95% CI 1.077 - 1.143). Female sex (HR 0.54 95% CI 0.376 - 0.782), the presence of headache (HR 0.61, 95% CI 0.406 - 0.916) and high hemoglobin levels (HR 0.85, 95% CI 0.748 - 0.967) were protective factors for death.

Conclusion: The overall GCA mortality rate in Spain is 11.83 per 100 patients, with infection being the most frequent cause of death. Older age is associated with an increased risk of mortality, whereas female sex, headache, and high hemoglobin levels were identified as protective factors against death.

Acknowledgements: The authors thank Javier Prado Galbarro for the statistical analysis.

Disclosure of Interests: Juan Molina-Collada: None declared, Marta Dominguez-Alvaro: None declared, Rafael B Melero-González: None declared, Eugenio De Miguel Abbvie, Novartis, Roche, Pfizer, Janssen, Lilly, MSD, BMS, UC Pharma, Grünenthal and Sanofi, Maite Silva-Díaz: None declared, Jesús Alejandro Valero Jaimes: None declared, Ismael González: None declared, Julio Sanchez-Martín: None declared, Javier Narváez: None declared, Joan Calvet: None declared, Ivette Casafont-Solé: None declared, Jose Andrés Román-Ivorra: None declared, Selene Labrada-Arrabal: None declared, Margarida Vasques-Rocha: None declared, Carlota L Iñiguez Pfizer, AbbVie, Fresenius - Kiabi, Novartis, GSK, Sanofi y Janssen, Sagrario Bustabad Reyes: None declared, Cristina Campos Fernández: None declared, María Alcalde Villar: None declared, Antonio Juan Mas: None declared, Ricardo Blanco AbbVie, Pfizer, Roche, Lilly, UCB, Bristol-Myers, Janssen, and MSD., AbbVie, MSD, and Roche.