Infection Risk Increased in Giant Cell Arteritis Save

French researchers recruited 486 patients with giant cell arteritis (GCA) from over 40 centers throughout France, and compared their outcomes to age and sex matched individuals randomly selected from the general population. Both groups were followed for 5 years and assessed for the risk of serious infections.

The GCA population was predominantly female with a mean age of 75 years. The diagnosis of GCA was temporal artery biopsy confirmed in 76% of the patients, and an elevated ESR (>50 mm/hour) was seen in 91.5% of the patients. 

Severe infections were twice as frequent in GCA patients during the first year after diagnosis, but thereafter was the same as that in the general population controls. 

The incidence rate was 11.1/100 patient-years GCA and 5.9/100 patient-years among controls. The most common infections were pneumonia and pyelonephritis. Yet, mortality, septic shock and infectious colitis were more frequent among the patients with GCA.

Diabetes (HR 3.3) was a risk factor for infection-related death. And while the initial corticosteroid dose was not associated with infection-related mortality, the corticosteroid dosage that was >10 mg/day after 12 months of treatment was associated with infection-related mortality (HR 4.61).

The authors concluded that the risk of infection increases in GCA patients with older age or in the presence of diabetes, or is greater when the dosage of corticosteroids has been increased to >10 mg/day after 12 months of treatment.