TY - JOUR T1 - Mortality among patients with giant-cell arteritis: A large-scale population-based cohort study JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.190927 SP - jrheum.190927 AU - Niv Ben-Shabat AU - Shmuel Tiosano AU - Ora Shovman AU - Doron Comaneshter AU - Yehuda Shoenfeld AU - Arnon D. Cohen AU - Howard Amital Y1 - 2019/12/15 UR - http://www.jrheum.org/content/early/2019/12/09/jrheum.190927.abstract N2 - Objective Studies regarding mortality among patients with giant-cell-arteritis (GCA) have yielded conflicting results. Thus, in this large population-based study we aimed to examine whether GCA is associated with increased mortality, and if so, the effect of age at diagnosis and gender on the association. Methods We utilized the medical database of Clalit-Health-Services for this retrospective cohort study. Follow-up was from January 1,2002 and continued until death or end of follow-up on September 1,2018. Incident GCA patients were compared with age-and-sex-matched controls. Estimated median survival-times were calculated using Kaplan-Meier method. Hazard-ratios for all-cause-mortality were obtained by the Cox proportional-hazard model, adjusted for sociodemographic variables and cardiovascular risk factors. Results The study included 7,294 GCA patients and 34,156 controls. The mean age at start of follow-up was 72.1±9.9 years with 69.2% females. Estimated median survival-time was 13.1 years (95% CI, 12.6-13.5 years) in GCA patients compared with 14.3 years (95% CI, 14.1-14.6) in controls (P-value < 0.001).The multivariate analysis demonstrated increased mortality risk in the first 2 years after diagnosis (HR 1.14; 95% CI 1.04-1.2) and >10 years after diagnosis (HR 1.14; 95% CI 1.02-1.3). The mortality-risk was higher in patients diagnosed ≤70 years of age (HR 1.5(95% CI 1.14-1.99) 0-2 years; HR 1.38(95% CI 1.1-1.7) >10 years). Conclusion GCA patients have a minor decrease in long-term survival compared to age-andsex-matched controls. The seen difference is due to excess mortality in the first 2 years, and >10 years after diagnosis. Patients diagnosed ≤70 years of age are at greater risk. ER -