Objectives To investigate the incidence and mortality of biopsy proven giant cell arteritis (GCA) over a 27-year period in a defined area of northern Italy.
Methods All patients with incident GCA diagnosed from January 1, 1986 to December 31, 2012 living in the Reggio Emilia area were identified through computerized hospital discharge diagnosis and a structured review of all histopahology reports. Patients were followed up from the time of diagnosis until either their death or December 31, 2013.
Results Two hundred and eighty-seven patients (76 men and 211 women) had biopsy proven GCA according to the histopathological examination. Mean±SD age at diagnosis was 74.3±7.4 years. The mean annual incidence rate (IR) of GCA was 23.08/106 (95% CI: 20.5-25.9). The mean IR was 33.3/106 (95% CI: 29.0-38.1) among women and 12.4/106 (95% CI: 9.8-15.5) for men (p not significant). The lowest IR occurred in male patients in the 50-59 years age group (5.13/106; 95% CI: 1.4-13.1), the highest IR was observed in female patients 70-79 years age group (153.6/106; 95% CI: 124.7-187.2). IR difference between sex was significant only in the 60-69 age group (IR male/female 14.6/67.1,95% CI 7.0-26.9 vs 49.8-88.4). The average annual IR increased from 5.63/106 during 1986-1988 to 45.23/106 during 1998-2000 period and was stable thereafter with IR of 30-23/106.At histological examination 13.6% (39 pts) had only small vessels perivascular involvement (adventitial vasa vasorum and peri-adventitial capillaries). Prevalence of small vessels involvement was significant higher among male patients (male 30% vs 7%female, p<0.001).One hundred and twenty-one patients (42.2%) died during the follow-up period (median survival after diagnosis 152 months [range 4-320 months]). Survival did not differ nor between gender or between different histopathological pattern.
Conclusions This population-based study is the first to report the incidence of biopsy proven GCA in Italy. Our average annual IR is similar to that reported in the period 1984-1988 in Finland (1). Unlike the Spanish data our annual IR is higher among women than among men (2).
Franzén P, Sutinen S, von Knorring J. Giant cell arteritis and polymyalgia rheumatica in a region of Finland: an epidemiologic, clinical and pathologic study, 1984-1988. J Rheumatol. 1992;19:273-6.
Gonzalez-Gay MA, Miranda-Filloy JA, Lopez-Diaz MJ, Perez-Alvarez R, Gonzalez-Juanatey C, Sanchez-Andrade A, Martin J, Llorca J. Giant cell arteritis in northwestern Spain: a 25-year epidemiologic study. Medicine (Baltimore). 2007;86:61-8.
Disclosure of Interest None declared