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Concomitant association of giant cell arteritis and malignancy: a multicenter retrospective case-control study

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Abstract

Introduction

Some studies suggest that there is an increased risk of malignancies in giant cell arteritis (GCA). We aimed to describe the clinical characteristics and outcomes of GCA patients with concomitant malignancy and compare them to a GCA control group.

Method

Patients with a diagnosis of GCA and malignancy and with a maximal delay of 12 months between both diagnoses were retrospectively included in this study and compared to a control group of age-matched (3:1) patients from a multicenter cohort of GCA patients.

Results

Forty-nine observations were collected (median age 76 years). Malignancies comprised 33 (67%) solid neoplasms and 16 (33%) clonal hematologic disorders. No over-representation of a particular type of malignancy was observed. Diagnosis of GCA and malignancy was synchronous in 7 (14%) patients, while malignancy succeeded GCA in 29 (59%) patients. Malignancy was fortuitously diagnosed based on abnormalities observed in laboratory tests in 26 patients, based on imaging in 14 patients, and based on symptoms or clinical examination in the nine remaining patients. Two patients had a concomitant relapse of both conditions. When compared to the control group, patients with concomitant GCA and malignancy were more frequently male (p < 0.001), with an altered general state (p < 0.001), and polymyalgia rheumatica (p < 0.01).

Conclusions

This study does not indicate an over-representation of any particular type of malignancy in GCA patients. Initial follow-up dictated by vasculitis may have led to an early identification of malignancy. Nevertheless, GCA male patients with an altered general state and polymyalgia rheumatica might more frequently show concomitant malignancies.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine and Clinical Immunology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Avenue de la Côte de Nacre, 14000, Caen, France

    S. Deshayes, A. Dumont, A. Aouba & H. de Boysson

  2. Department of Internal Medicine, CHU Limoges, Limoges, France

    E. Liozon

  3. Department of Internal Medicine, Hôpital Bichat, Paris, France

    N. Chanson & K. Sacré

  4. Department of Internal Medicine, Hôpitaux Privés de Metz, Metz, France

    T. Moulinet

  5. Department of Internal Medicine, Centre Hospitalier Georges Renon, Niort, France

    C. Blanchard-Delaunay

  6. Department of Internal Medicine, CHU Nantes, Nantes, France

    O. Espitia

  7. Department of Internal Medicine, National Referral Center for Hypereosinophilic Syndromes (CEREO), Hôpital Foch, Suresnes, France

    M. Groh

  8. Institut Arnault Tzanck, Saint Laurent du Var, France

    M. Versini

  9. Department of Internal Medicine, CHU Rennes, Rennes, France

    T. Le Gallou

  10. Department of Internal Medicine, Hôpital Ambroise Paré, Boulogne Billancourt, France

    J.-E. Kahn

  11. Department of Internal Medicine, CHU Estaing, Clermont-Ferrand, France

    V. Grobost

  12. Department of Internal Medicine, CHU de Besançon, Besançon, France

    S. Humbert

  13. Department of Internal Medicine and Clinical Immunology, CHU Dijon, Dijon, France

    M. Samson

  14. Department of Internal Medicine, Hôpital Civil, Strasbourg, France

    R. Mourot Cottet

  15. Department of Internal Medicine, Hôpital de la Conception, Marseille, France

    K. Mazodier

  16. Department of Internal Medicine, CHU Grenoble, Grenoble, France

    A. Dartevel

  17. Department of Infectious and Systemic Diseases, Hôpital d’Instruction des Armées, Metz, France

    J. Campagne

  18. Department of Internal Medicine, Hôpital Saint Joseph, Marseille, France

    B. Bienvenu

  19. Department of Internal Medicine, CHU de Lille, Lille, France

    M. Lambert

  20. Department of Geriatric and Internal Medicine, CHU de Marseille, Marseille, France

    A. Daumas

  21. Department of Internal Medicine, Hôpital Pitié Salpétrière, Paris, France

    D. Saadoun

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  1. S. Deshayes
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  2. E. Liozon
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  25. H. de Boysson
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Consortia

on behalf of the French Study Group for Large Vessel Vasculitis (GEFA)

Corresponding author

Correspondence to H. de Boysson.

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Ethical standards

This study was conducted in compliance with good clinical practices and the Declaration of Helsinki principles. At the time of this study, in accordance with French public health law (Art. L 1121-1-1, Art. L 1121-1-2), formal approval from an ethics committee was not required for this type of observational study. Our local ethics committee confirmed the observational non-interventional retrospective nature of our cohort.

Conflicts of interest

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Maxime Samson declares invitations to congresses by Abbvie, Roche Chugaï, Actelion, Novartis and LFB; symposium for Roche Chugaï and belongs to scientific committee of Roche Chugaï. The other authors declare that they have no relevant financial interests.

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Deshayes, S., Liozon, E., Chanson, N. et al. Concomitant association of giant cell arteritis and malignancy: a multicenter retrospective case-control study. Clin Rheumatol 38, 1243–1249 (2019). https://doi.org/10.1007/s10067-018-04407-y

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