Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Age At Onset and Gender Are Associated with Differences in Giant Cell Arteritis (GCA) Initial Presentation and Outcome.
Alba, Marco A., Garcia-Martinez, Ana, Tavera-Bahillo, Itziar, Prieto-Gonzalez, Sergio, Espigol, Georgina, Hernandez-Rodriguez, Jose, Cid, Maria C.
GCA is a chronic inflammatory disease involving large and medium-sized arteries. It is considered the most frequent primary vasculitis with higher incidence in women. Mean age of onset in different cohorts ranges between 7274 years. Former studies have observed certain differences in GCA clinical spectrum depending on age at disease presentation and gender. Particularly polymyalgia rheumatica has been found to be more frequent in women and in patients younger than 70 years. The purpose of this study was yo evaluate differences in initial clinical manifestations, ischemic complications and clinical course according to age at onset and gender in a prospectively followed cohort of patients with biopsy-proven giant cell arteritis.
Between 1995 and 2005, 170 patients were diagnosed with biopsy proven GCA at our institution. Among them, patients with the following criteria were selected: prospective treatment by the authors according to uniform criteria, prospective recording of GCA-presentation, related complications, relapses, periodic screening for aneurysm, glucocorticosteroid doses, and follow-up duration of at least 4 years.
Based on the mean ± standard deviation (SD) of age at disease onset, patients were classified in 3 groups: age equal or below 67 years (mean -1SD) (early onset), age between 68 and 80 years, and age equal or older than 81 (mean+1SD) (late onset). Ninety-four patients fulfilled the selection criteria and were eligible for this study. Although retrospective in design, the study was performed on a prospectively followed cohort. Chi-square test, ANOVA test and Kaplan-Meyer survival analysis/log-rank test were used for statistical comparison.
Mean age (±SD) at diagnosis was 74±7 years (5889). Patients with early onset GCA (<=67 years) presented more frequently fever (p=0.002), and had higher erythrocyte sedimentation rate (0.039) than patients >68 years. Subsequent clinical course of this group did not differ from patients with disease onset between 6880 years and >81 years. In contrast, late onset GCA (>=81 years) was characterized by higher prevalence of severe ischemic complications in the form of amaurosis fugax (6% for <=67 years vs 9% for 6880 vs 29% for >=81 years, p=0.046) and blindness (6% for <=67 years vs 7% for 6880 vs 33% for >=81 years, p=0.006). During follow-up, late onset GCA patients relapsed less frequently (p=0.027). Concerning to gender, we found no differences in the initial clinical presentation between men and women but men developed more frequently aortic aneurysm during follow-up (p=0.003).
Age at onset and gender are associated with differences in clinical presentation and outcome in patients with GCA
Supported by SAF 08/04328, Marato TV3 06/0710 and Consejo Nacional de Ciencia y Tecnología (CONACyT)
To cite this abstract, please use the following information:
Alba, Marco A., Garcia-Martinez, Ana, Tavera-Bahillo, Itziar, Prieto-Gonzalez, Sergio, Espigol, Georgina, Hernandez-Rodriguez, Jose, et al; Age At Onset and Gender Are Associated with Differences in Giant Cell Arteritis (GCA) Initial Presentation and Outcome. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1523