Conference Coverage

Heart disease in GPA exacts high toll in year 2 and beyond

 

Key clinical point: Mortality is high in granulomatosis with polyangiitis (GPA), with later deaths more likely due to factors other than active disease.

Major finding: The main cause of death changed from active disease (40% of all cases) within the first year to cardiovascular disease at years 1-5 (37.5%).

Study details: Retrospective cohort study of 465 individuals newly diagnosed with granulomatosis with polyangiitis matched to 4,610 controls from the general U.K. primary care population.

Disclosures: Arthritis Research UK funded the trial. Dr. Pearce had nothing to disclose.

Source: Pearce F et al. Rheumatology. 2018;57(Suppl. 3):key075.204.


 

REPORTING FROM RHEUMATOLOGY 2018

– Cardiovascular disease was the predominant cause of death of patients with granulomatosis with polyangiitis 1-5 years after a diagnosis in a study by U.K. researchers, suggesting that this could be a target for future intervention.

While active disease was the No. 1 cause of death within the first year of diagnosis in 40% of patients with granulomatosis with polyangiitis (GPA), it was overtaken by cardiovascular disease (CVD) as the main cause of death in 37.5% of patients in the next 4 years from diagnosis.

Dr. Fiona A. Pearce of the division of epidemiology and public health at the University of Nottingham, England. Sara Freeman/MDedge News

Dr. Fiona A. Pearce

Nevertheless, active disease remained an important cause of death, accounting for 10% of deaths at 1-5 years, 18.2% at 5-10 years, and 16.7% at 10-15 years.

“The idea for this study came from patients with vasculitis who were polled by Vasculitis UK,” Fiona A. Pearce, MBBS, explained at the British Society for Rheumatology annual conference.

“Further research into mortality was one of their top priorities as patients want to know the honest truth about what is going to happen to them,” added Dr. Pearce, of the division of epidemiology and public health at the University of Nottingham (England).

GPA is a rare type of vasculitis that is estimated to occur in around 1,350 people every year in the United Kingdom. Mortality is known to be high, with around 11%-14% of patients dying in the first year of diagnosis, but there are few data on what happens over a longer term.

The aim of the study was therefore to examine patient survival in the long term – what were the mortality rates several years post diagnosis? Did the risk of death remain high throughout this time and did the causes of death change?

Pages

Next Article:

   Comments ()