Pos0694 Relative Risk of Cardiovascular and Thrombotic Events Among Patients With Giant Cell Arteritis Compared With Rheumatoid Arthritis and Matched Controls: A Cohort Study Using Us Claims Data

Background: Immune-mediated inflammatory diseases such as giant cell arteritis (GCA) and rheumatoid arthritis (RA) may increase patients' risk for cardiovascular (CV) and thrombotic events 1-4. The risk for CV or venous thromboembolism (VTE) events in GCA relative to RA is not well known. Objectives: To describe the relative risk of myocardial infarction or stroke (MI/stroke) and VTE events in patients with GCA compared with RA and a matched control cohort unaffected by GCA, and to explore how baseline demographics, comorbidities, and select medications contribute to the underlying risk of such events in patients with GCA. Methods: This retrospective, observational, comparative cohort study used US claims data (Optum Clinformatics® Data Mart; 1 Jan 2014–30 Sep 2022) from adults aged ≥ 50 years with GCA or RA; non-GCA controls were matched 1:1 to patients in the GCA cohort (but not the RA cohort) by age, sex, and cohort entry date (CED). Control patients were not excluded for other comorbidities. Patients had ≥ 12 months of baseline claims data before diagnosis or CED and ≥ 1 day of follow-up data, and were followed until the earliest date of either a MI/stroke or VTE, disenrollment, death, or analysis period end. The primary outcomes were an inpatient (IP) hospitalized MI/stroke or VTE (deep vein thrombosis, pulmonary embolism) diagnosis. A secondary outcome for VTE included diagnoses for IP VTE or outpatient (OP) VTE (2 OP diagnoses within 7–‍185 days of each other, or 1 OP diagnosis and anticoagulant initiation within ≤ 7 days). MI/stroke and VTE cases per 100 person-years (PY) were reported. The relative risk (for GCA vs RA or controls) and the risk by baseline characteristics (in GCA) for MI/stroke and VTE were estimated with the Cox proportional hazards regression model adjusted for baseline demographics, comorbidities, and medications. Results: Data from 17,148 patients with GCA and non-GCA–matched controls (mean SD age, 75.1 8.5 years; 72.1% female), and 379,764 patients with RA (age, 73.0 9.5 years; 73.2% female) were included. Systemic corticosteroids (SCS) were used in the 90 days before diagnosis or CED by 43.0%, 28.3%, and 13.5% of patients in the GCA, RA, and control groups, respectively. Among the GCA cohort, 2303 IP MI/stroke cases were observed during 45,921 PY of follow-up. The crude IP MI/stroke incidence rate (95% CI) was higher for patients with GCA (5.02 4.81, 5.22 cases/100 PY) vs RA (3.02 2.99, 3.05) and non-GCA–matched controls (3.46 3.29, 3.64). Among the GCA cohort, 495 cases of IP VTE were observed during 49,489 PY of follow-up. The crude IP VTE incidence rate was higher for patients with GCA (1.00 0.91, 1.09 cases/100 PY) vs RA (0.69 0.68, 0.71) and non-GCA–matched controls (0.62 0.55, 0.70). The adjusted relative IP MI/stroke or VTE risk was higher for patients with GCA than RA and controls (Figure 1). For patients with GCA, the risk for IP MI/stroke was ≥ 30% higher in those with a history of ischemic heart disease, hypertension, diabetes, or congestive heart failure (Figure 2). For patients with GCA, the risk for IP VTE was ≥ 30% higher in those who were obese, had a VTE history, hospitalization in the past year, or received non-steroidal anti-inflammatory drugs or SCS in the 90 days before GCA diagnosis. Trends were similar with both IP and OP VTE. Conclusion: GCA was associated with a higher underlying risk for MI/stroke and VTE relative to RA and non-GCA–matched controls, which persisted after adjusting for baseline demographics, comorbidities, and select medications. This study also investigated baseline risk factors for MI/stroke and VTE in patients with GCA. When evaluating the risk of MI/stroke or VTE in patients with GCA, considering an individual's medical history and comorbidities may inform treatment benefit-risk assessments. REFERENCES: 1 Molander V, et al. Ann Rheum Dis. 2022;81:517–8. 2 del Rincón ID, et al. Arthritis Rheum. 2021;44:2737–45. 3 Michailidou D, et al. J Intern Med. 2022;291:665–75. 4 Tomasson G, et al. Ann Intern Med. 2014;160:73–80. Acknowledgements: AbbVie funded this study and participated in the study design, research, analysis, data collection, interpretation of data, reviewing, and approval of the abstract. All authors had access to relevant data and participated in the drafting, review, and approval of this abstract. No honoraria or payments were made for authorship. AbbVie and authors thank all the trial investigators and the patients who participated in the study. Medical writing support was provided by Morgan A Gingerich, PhD, of JB Ashtin, and funded by AbbVie. Disclosure of Interests: Whitney Krueger WK is a full-time employee of AbbVie and may hold AbbVie stock or stock options., Xiaomeng Yue XY is a full-time employee of AbbVie and may hold AbbVie stock or stock options., Ivan Lagunes IL is a full-time employee of AbbVie and may hold AbbVie stock or stock options., Arathi Setty AS is a full-time employee of AbbVie and may hold AbbVie stock or stock options., Cristina Ponte CP has received research grants and/or consultancy fees from AbbVie, AstraZeneca, GSK, Vifor, and Roche., Ana Romero AR is a full-time employee of AbbVie and may hold AbbVie stock or stock options.