Incidence Trends and Mortality of Giant Cell Arteritis in Southern Norway

Abstract

Objective. Southern Norway consists of a homogeneous population of nearly 300,000 inhabitants and is an ideal epidemiologic setting. We aimed to explore potential changes in incidence of giant cell arteritis (GCA) in Southern Norway from 2000-2013, with comparisons of previous reports from the same population cohort from 1987-1994 and 1992-1996, and to investigate the mortality rates of GCA over a period of 14 years. Methods. All patients diagnosed with GCA during January 1, 2000 to December 31, 2013 were identified through the electronic health records and biopsy findings databases at our clinic. The diagnosis of GCA and information about death was confirmed by reviewing the patients' hospital records. Inclusion criteria were: 1) fulfillment of the American College of Rheumatology 1990 criteria for GCA, or 2) histologically proven GCA, or 3) confirmed arteritis of the large or medium-sized vessels by imaging. Results. A total of 206 patients were included, and 147 (72%) were females. The annual incidence rate of GCA per 100,000 inhabitants age ≥50 years was 16.8 (95% confidence interval [95% CI] 14.6-19.2), 24.5 for females (95% CI 19.2-26.5), and 10.2 for males (95% CI 7.9-13.2). Forty-six patients (22%) died (24 women, 22 men). The overall standardized mortality ratio was 1.05 (95% CI 0.77-1.38), 0.92 for females (95% CI 0.61-1.35), and 1.38 for males (95% CI 0.88-2.05). Overall survival rate was significantly higher in females compared to males (P < 0.001). Conclusion. GCA incidence is not increasing. We did not find excess mortality; however, males seem to have a worse survival rate compared to females.

Giant cells in temporal artery biopsies are associated with a reduced risk of large vessel involvement in patients with giant cell arteritis : a retrospective cohort study

“…Strengths of this study include the population-based study design, the relatively large patient cohort with a long follow-up period, and the systematic review of pathology reports. Furthermore, we focused on objectively veri ed (biopsy-proven) GCA, which had an incidence in our population that was similar to other studies of Scandinavian populations [2,50].…”

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

“…Studies regarding mortality among patients with GCA have yielded conflicting results. 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].…”

One Giant Step for Giant Cell Arteritis: Updates in Diagnosis and Treatment

“…However, a recent study found a negative association between fasting blood glucose levels and risk of GCA, suggesting that lower levels of glucose metabolites like pyruvate might lead to reduced expression of programmed death ligand 1 (PD-L1) on macrophages, predisposing to T cell activation and exacerbation of chronic vascular inflammation in GCA [26]. A recent study in Norway did not find worsened mortality in patients with GCA, although mortality in male GCA patients was worse than females [27]. However, a French study did find increased mortality in GCA patients, especially from vascular disease [28].…”