Vasculitis & polymyalgia rheumatica
Age at diagnosis influences the clinical phenotype, treatment strategies and outcomes in patients with giant cell arteritis: results from the observational GCAGE study on a large cohort of 1004 patients
Authors' conclusion
The highest risk of ischaemic complications, aneurysm development, serious infections and the possible undertreatment make of GCA a very challenging disease in the oldest patients.
Study context
- Population
- Patients with giant cell arteritis (GCA) followed at referral centres within the Italian Society of Rheumatology Vasculitis Study Group, enrolled up to November 2021mean age 72.1±8.4
- Participants
- 1,004 patients
- Exposure
- Age at diagnosis ≥80 vs 65-79 vs ≤64 years
- Outcome
- Blindness
Methodological detailsmulticentre, referral centres
- Multicentre
- Referral centres
Main finding
As reported in the abstract
P < 0.0001
Observational data: associations, not effects.
Further findings
- Large-vessel-GCA — ≤64
- 65%
Large-vessel-GCA
- More frequent in the youngest group
Relapses · median follow-up 49 (IQR 23-91) months
- Relapses occurred in all patients
- 47%
- Age did not influence time to first relapse nor number of relapses
Adjunctive immunosuppressants
- Older age negatively associated with number of adjunctive immunosuppressants
Aortic aneurysm/dissection · up to 60 months follow-up
- Patients >65 years: increased risk (fold)
- 2-3
Mortality
- Mortality in the population
- 5.8%
- Independent risk factors: age >65, cranial and systemic symptoms
Safety
Treatment-related complications
- Serious infections significantly associated with older age
- Hypertension, diabetes, osteoporotic fractures not significantly associated with older age
Original publication
Age at diagnosis influences the clinical phenotype, treatment strategies and outcomes in patients with giant cell arteritis: results from the observational GCAGE study on a large cohort of 1004 patients. Ann Rheum Dis. Published 15 May 2023. doi:10.
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