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Overall and cause-specific mortality in giant cell arteritis

A meta-analysis

Gesamt- und ursachenspezifische Mortalität bei Riesenzellarteriitis

Eine Metaanalyse

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Abstract

Objective

This study aimed to assess the all-cause and cause-specific standardized mortality ratios (SMRs) in patients with giant cell arteritis (GCA).

Methods

We surveyed studies examining all-cause and/or cause-specific SMRs in patients with GCA compared to the general population, using MEDLINE, EMBASE, Cochrane databases, and manual searches. We then performed a meta-analysis of all-cause, sex-specific, region-specific, and cause-specific SMRs in patients with GCA.

Results

In total, 8 reports including 1972 patients with GCA (including 877 patients who died) met the inclusion criteria. Compared with the general population, all-cause SMR was not increased in patients with GCA (SMR 1.081, 95% confidence interval [CI] 0.963–1.214, p = 0.184). Stratification by region showed no significant increase in all-cause SMR in Europe and USA. Sex-specific meta-analysis revealed that the pooled SMR was 1.046 (95%CI 0.834–1.314, p = 0.696) for women and 1.051 (95%CI 0.974–1.133, p = 0.204) for men. There were no sex-specific significant differences in SMR. The risk of mortality due to cardiovascular disease (CVD) was significantly increased (SMR 1.312, 95%CI 1.136–1.516, p < 0.001). However, there was no significant increase in the SMR for mortality due to cancer (SMR 0.833, 95%CI 0.613–1.132, p = 0.243).

Conclusions

Patients with GCA do not show increased rates of death from all causes, regardless of sex, region, or malignancy. However, these patients are at an increased risk of death due to CVD.

Zusammenfassung

Ziel

Ziel der Studie war es, standardisierte Mortalitätsverhältnisse („standardized mortality ratios“ [SMR]) in Bezug auf die Gesamt- und ursachenspezifische Mortalität bei Patienten mit Riesenzellarteriitis (RZA) zu bestimmen.

Methoden

In MEDLINE, EMBASE und Cochrane-Datenbanken sowie manuell wurde nach Studien zu Gesamt- und/oder ursachenspezifischen SMR bei RZA-Patienten im Vergleich zur Allgemeinbevölkerung gesucht. Daraufhin wurde eine Metaanalyse der Gesamt-, geschlechtsspezifischen, regionsspezifischen und ursachenspezifischen SMR bei Patienten mit RZA durchgeführt.

Ergebnisse

Insgesamt 8 Publikationen mit 1972 RZA-Patienten (einschließlich 877 Patienten, die verstarben) erfüllten die Einschlusskriterien. Im Vergleich zur Allgemeinbevölkerung war das Gesamt-SMR bei Patienten mit RZA nicht erhöht (SMR 1,081, 95%-Konfidenzintervall [KI] 0,963–1,214, p = 0,184). Die regionale Stratifikation ergab keine signifikante Erhöhung des Gesamt-SMR in Europa und den USA. Eine geschlechtsbezogene Metaanalyse ergab ein gepooltes SMR von 1,046 (95%-KI 0,834–1,314, p = 0,696) für Frauen und 1,051 (95%-KI 0,974–1,133, p = 0,204) für Männer. Es fanden sich keine signifikanten geschlechtsspezifischen Unterschiede im SMR. Das Mortalitätsrisiko bedingt durch kardiovaskuläre Erkrankungen war signifikant erhöht (SMR 1,312, 95%-KI 1,136–1,516, p < 0,001). Hinsichtlich des SMR für tumorbedingte Mortalität war dagegen keine signifikante Erhöhung festzustellen (SMR 0,833, 95%-KI 0,613–1,132, p = 0,243).

Schlussfolgerungen

Patienten mit RZA weisen keine erhöhten Gesamtsterberaten auf, unabhängig von Geschlecht, geografischer Region oder Malignität. Die Patienten haben aber ein erhöhtes Sterberisiko bedingt durch kardiovaskuläre Erkrankungen.

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Acknowledgements

This research received no specific grant from any public, commercial, or not-for-profit sectors funding agency.

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Authors and Affiliations

  1. Department of Rheumatology, Korea University Anam Hospital, Korea University College of Medicine, 73, Inchon-ro, 02841, Seoul, Seongbuk-gu, Korea (Republic of)

    Y. H. Lee MD, PhD & G. G. Song

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  1. Y. H. Lee MD, PhD
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  2. G. G. Song
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Corresponding author

Correspondence to Y. H. Lee MD, PhD.

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Y. H. Lee and G. G. Song declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

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U. Müller-Ladner, Bad Nauheim

U. Lange, Bad Nauheim

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Lee, Y.H., Song, G.G. Overall and cause-specific mortality in giant cell arteritis. Z Rheumatol 77, 946–951 (2018). https://doi.org/10.1007/s00393-018-0440-7

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  • DOI: https://doi.org/10.1007/s00393-018-0440-7

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