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First-year diagnosis of giant cell arteritis yields higher rate of infection, mortality
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A higher rate of infection and infection-related mortality was found during the first year of diagnosis for giant cell arteritis, according to recent research published in Arthritis & Rheumatology.
J. Schmidt, MD, PhD, from the Amiens University Hospital and Jules Verne University of Picardy in Amiens, France, and colleagues evaluated 486 patients with giant cell arteritis (GCA) and matched against age- and gender-matched control patients from the general population who were prospectively followed up for 5 years, according to the abstract.
They found an incidence rate ratio of 2.1 for severe infections among patients with GCA compared with patients in the general population (95% CI, 1.2-3.4; incidence rate, 11.1/100 patient-years vs. 5.9/100 patient-years) with septic shock and infectious colitis more prevalent in patients with GCA. There was a higher rate of mortality in patients with GCA according to a log-rank test (P < .0001), with a higher rate of mortality from severe infection in patients with a diabetes diagnosis (HR = 3.3; 95% CI, 1.4-7.7) and greater than 10 mg/day dosage of corticosteroids after 12 months of treatment (HR = 4.61; 95% CI, 1.38-15.36), according to the abstract. The researchers noted a higher rate of mortality among patients with GCA in the early part of enrollment in the study, which then decreased to a comparable mortality rate of the general population (P = .0001).
“Close clinical monitoring, early antibiotic treatment and specific screening for tuberculosis before treatment may be ways to reduce the occurrence of severe infections in patients with GCA,” Schmidt and colleagues wrote. “Further trials testing strategies to spare corticosteroid treatments may be of interest, with particular attention paid to potential complications related to infections caused by immunosuppressive drugs.” – by Jeff Craven
Disclosure: The researchers report no relevant financial disclosures.
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