POS0960 LONG TERM MORTALITY OF PATIENTS WITH GIANT CELL ARTERITIS: CAUSES AND PREDICTORS IN A LARGE CONTEMPORARY PATIENT COHORT

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Background: There are limited data on the long-term mortality rates, its causes and predictors in patients with giant cell arteritis (GCA). Objectives: To evaluate the long-term mortality rate, causes of death, and its predictors in a real-world GCA patient cohort. Methods: Multicenter, prospective cohort of patients with GCA who were cross-sectionally evaluated between 2015 and 2019 (GCA study group - Greek Rheumatology Society, ERE-EPERE). Patient and treatment data were collected at baseline, 2 and 5 years later. Survival outcomes between groups were compared using the Peto-Peto test and the Log-rank test. Multivariable Cox propotional hazards regression was used to further evaluate potential risk factors. Results: A total of 241 GCA patients were analyzed: 68% were women with a mean age at diagnosis of 73.2 years and a median follow-up of 5 years (IQR: 3.0 – 7.5). During follow-up, 27 patients (11.1%) died (Figure 1), with an estimated death rate of 19.9 deaths per 1,000 person-years of follow-up. The exact cause of death was available for 18 patients, attributed to cardiovascular events (n=7, 26%), infections (n=3, 11%), and malignancies (n=2, 7%). Survival outcome was compared across subgroups: sex, large vessel involvement, cardiovascular disease, headache at diagnosis, use of DMARDS, relapses. Patients with cardiovascular disease at the time of diagnosis exhibited increased mortality (p Peto-Peto = 0.015), whereas patients who received ≥1 disease-modifying antirheumatic drug (DMARD) demonstrated a lower risk of death (p Log-rank < 0.001) (Figures 2A and 2B, respectively). When adjusted for sex and age, only the use of DMARDS was associated with lower risk of death [HR=0.19, 95% CI: 0.07-0.53]. Conclusion: In this real-life cohort of GCA patients, the mortality rate was on the higher end compared to previous studies (10-20 deaths/1,000 person-years). Patients who had not been treated with DMARDS and those with cardiovascular disease at diagnosis had a higher mortality rate. These findings emphasize the need for closer follow-up and better disease control of patients with GCA. Figure 1Overall Survival. Figure 2Survival by: Α. Cardiovascular disease at diagnosis B. Use of DMARDs during follow-up. REFERENCES: NIL . Acknowledgements: Supported in part by the Greek Rheumatology Society and Professional Association of Rheumatologists (ERE-EPERE) and the Special Account for Research Grants (S.A.R.G.), National and Kapodistrian University of Athens, Athens, Greece (DV #12085, 12086). Disclosure of Interests: None declared . © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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