Mortality among Patients with Giant Cell Arteritis: A Large-scale Population-based Cohort Study

Ben-Shabat, Niv; Tiosano, Shmuel; Shovman, Ora; Comaneshter, Doron; Shoenfeld, Yehuda; Cohen, Arnon D; Amital, Howard

doi:10.3899/jrheum.190927

Cited by 22 publications

(17 citation statements)

References 39 publications

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“…Within the database, diagnoses are going through a constant process of validation by logistic checks (such as matching the diagnoses from different sources). These diagnoses were found to be highly reliable, as shown in previously published studies [34][35][36][37][38].…”

Section: Data Sourcesupporting

confidence: 79%

Low Vitamin D Levels Predict Mortality in Ankylosing Spondylitis Patients: A Nationwide Population-Based Cohort Study

et al. 2020

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In this study, we aimed to examine the effect of vitamin D deficiency on all-cause mortality in ankylosing spondylitis (AS) patients and in the general population. This is a retrospective-cohort study based on the electronic database of the largest health-maintenance organization in Israel. AS patients who were first diagnosed between 2002–2007 were included. Controls were matched by age, gender and enrollment-time. Follow-up continued until death or end of study follow-up on 1 July 2019. Laboratory measures of serum 25-hydroxyvitamin-D levels during the entire follow-up period were obtained. A total of 919 AS patients and 4519 controls with a mean time of follow-up of 14.3 years were included. The mean age at the time of enrollment was 52 years, and 22% of them were females. AS was associated with a higher proportion of vitamin D deficiency (odds ratio 1.27 [95% confidence-interval (CI) 1.03–1.58]). In AS patients, insufficient levels of vitamin D (<30 ng/mL) were significantly associated with increased incidence of all-cause mortality (hazard ratio (HR) 1.59 [95% CI 1.02–2.50]). This association was more prominent with the decrease in vitamin D levels (< 20 ng/mL, HR 1.63 [95% CI 1.03–2.60]; <10 ng/mL, HR 1.79 [95% CI 1.01–3.20]) and among male patients (<30 ng/mL, HR 2.11 [95% CI 1.20–3.72]; <20 ng/mL, HR 2.12 [95% CI 1.19–3.80]; <10 ng/mL, HR 2.23 [95% CI 1.12–4.43]). However, inadequate levels of vitamin D among controls were not associated with an increased all-cause mortality. Our study has shown that vitamin D deficiency is more common in AS patients than controls and is linked to an increased risk for all-cause mortality. These results emphasize the need for randomized-controlled trials to evaluate the benefits of vitamin D supplementation as a secondary prevention of mortality in patients with chronic inflammatory rheumatic disease.

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Section: Data Sourcesupporting

confidence: 79%

Low Vitamin D Levels Predict Mortality in Ankylosing Spondylitis Patients: A Nationwide Population-Based Cohort Study

et al. 2020

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“…Several studies have reported that the life expectancy of patients with GCA does not significantly differ from that of the general population [40,43,44], while another study found that hospitalized GCA patients had lower mortality compared to the general inpatient population [45]. A recent large population-based study in Israel found that patients with GCA had a minor decrease in long-term survival [46]. The reasons why GCA was the vasculitis with the second highest mortality rate in our study are not known, but, in agreement with previous studies, it contributed significantly less than GPA to the overall vasculitis mortality.…”

Section: Discussionmentioning

confidence: 99%

Trend and Geographic Disparities in the Mortality Rates of Primary Systemic Vasculitis in the United States from 1999 to 2019: A Population-Based Study

Rodríguez-Pla

Rosselló-Urgell²

2021

JCM

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The current data on rates and geographic distribution of vasculitis mortality are limited. We aimed to estimate the mortality rates of primary systemic vasculitis and its geographic distribution using recent population data in the United States. The mortality rates of vasculitis from 1999 to 2019 were obtained from the Center for Disease Control (CDC) Wonder Multiple Cause of Death (MCD). The age-adjusted rates per million for vasculitis as MCD and as an underlying cause of death (UCD) were calculated by state using demographics. A joinpoint regression analysis was applied to evaluate trends over time. The age-adjusted mortality rate of vasculitis as MCD was 4.077 (95% CI: 4.029–4.125) and as a UCD was 1.888 per million (95% CI: 1.855–1.921). Since 1999, mortality rates have progressively decreased. The age-adjusted mortality rate was higher in females than in males. The highest mortality rate for vasculitis as MCD was in White patients (4.371; 95% CI: 4.317–4.424). The northern states and areas with lower populations had higher mortality rates. We found a trend of progressive decreases in the mortality rates of vasculitis, as well as gender, racial, and geographic disparities. Further analyses are warranted to better understand the factors associated with these disparities in order to implement targeted public health interventions to decrease them.

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“…We had insu cient data to analyze the SMR and cannot comment if the mortality relative to the age/gender matched population is changing. Controversy exists surrounding studies with an increased mortality in GCA [1,12,[23][24]26].…”

Section: Discussionmentioning

confidence: 99%

A meta-analysis of the epidemiology of Giant Cell Arteritis across time and space

Semenov

Turk

et al. 2021

Preprint

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Introduction: Giant cell arteritis (GCA) is a common large vessel vasculitis in those over age 50 years. This meta-analysis examined the geographical and temporal distribution of the incidence, prevalence and mortality of GCA.Methods: A systematic review was conducted using EMBASE, Scopus andPubMed from their inceptions until 2019. Studies were included if they reported at least 50 or more GCA patients and defined the location and time frame. Articles on mortality were included and standardized mortality ratio (SMR) was extracted where possible. Mean pooled prevalence, incidence, and SMR were calculated using a random effects model. Linear regression was used to explore correlations between latitude and incidence, prevalence, and mortality.Results: Of the 3569 citations identified, 107 were included. The pooled incidence of GCA was 10.00 [9.22, 10.78] cases per 100,000 people over 50 years old. This incidence was highest in Scandinavia 21.57 [18.90, 24.23], followed by North and South America 10.89 [8.78, 13.00], Europe 7.26 [6.05, 8.47], and Oceania 7.85 [-1.48, 17.19]. Pooled prevalence was 51.74 [42.04, 61.43] cases per 100,000 people over age 50. Annual mortality was 20.44 [17.84, 23.03] deaths/1000. Mortality generally decreased over the years of publication (p=0.0008). Latitude correlated significantly with incidence (p=0.0011), but not with prevalence, or mortality. Conclusions: GCA incidence varies nearly 3-fold between regions and is highest in Scandinavia but not significantly. Mortality may be improving over time.

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Mortality among Patients with Giant Cell Arteritis: A Large-scale Population-based Cohort Study

Cited by 22 publications

References 39 publications

Low Vitamin D Levels Predict Mortality in Ankylosing Spondylitis Patients: A Nationwide Population-Based Cohort Study

Low Vitamin D Levels Predict Mortality in Ankylosing Spondylitis Patients: A Nationwide Population-Based Cohort Study

Trend and Geographic Disparities in the Mortality Rates of Primary Systemic Vasculitis in the United States from 1999 to 2019: A Population-Based Study

A meta-analysis of the epidemiology of Giant Cell Arteritis across time and space

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