Concomitant association of giant cell arteritis and malignancy: a multicenter retrospective case-control study
Some studies suggest that there is an increased risk of malignancies in giant cell arteritis (GCA). We aimed to describe the clinical characteristics and outcomes of GCA patients with concomitant malignancy and compare them to a GCA control group.
Patients with a diagnosis of GCA and malignancy and with a maximal delay of 12 months between both diagnoses were retrospectively included in this study and compared to a control group of age-matched (3:1) patients from a multicenter cohort of GCA patients.
Forty-nine observations were collected (median age 76 years). Malignancies comprised 33 (67%) solid neoplasms and 16 (33%) clonal hematologic disorders. No over-representation of a particular type of malignancy was observed. Diagnosis of GCA and malignancy was synchronous in 7 (14%) patients, while malignancy succeeded GCA in 29 (59%) patients. Malignancy was fortuitously diagnosed based on abnormalities observed in laboratory tests in 26 patients, based on imaging in 14 patients, and based on symptoms or clinical examination in the nine remaining patients. Two patients had a concomitant relapse of both conditions. When compared to the control group, patients with concomitant GCA and malignancy were more frequently male (p < 0.001), with an altered general state (p < 0.001), and polymyalgia rheumatica (p < 0.01).
This study does not indicate an over-representation of any particular type of malignancy in GCA patients. Initial follow-up dictated by vasculitis may have led to an early identification of malignancy. Nevertheless, GCA male patients with an altered general state and polymyalgia rheumatica might more frequently show concomitant malignancies.
KeywordsGiant cell arteritis Hematologic neoplasms Malignancy Neoplasms
Compliance with ethical standards
This study was conducted in compliance with good clinical practices and the Declaration of Helsinki principles. At the time of this study, in accordance with French public health law (Art. L 1121-1-1, Art. L 1121-1-2), formal approval from an ethics committee was not required for this type of observational study. Our local ethics committee confirmed the observational non-interventional retrospective nature of our cohort.
Conflicts of interest
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Maxime Samson declares invitations to congresses by Abbvie, Roche Chugaï, Actelion, Novartis and LFB; symposium for Roche Chugaï and belongs to scientific committee of Roche Chugaï. The other authors declare that they have no relevant financial interests.
- 6.Fain O, Hamidou M, Cacoub P, Godeau B, Wechsler B, ParIès J, Stirnemann J, Morin AS, Gatfosse M, Hanslik T, Belmatoug N, Blétry O, Cevallos R, Delevaux I, Fisher E, Hayem G, Kaplan G, le Hello C, Mouthon L, Larroche C, Lemaire V, Piette AM, Piette JC, Ponge T, Puechal X, Rossert J, Sarrot-Reynauld F, Sicard D, Ziza JM, Kahn MF, Guillevin L (2007) Vasculitides associated with malignancies: analysis of sixty patients. Arthritis Rheum 57:1473–1480Google Scholar
- 10.Solans-Laque R, Bosch-Gil JA, Pérez-Bocanegra C et al (2008) Paraneoplastic vasculitis in patients with solid tumors: report of 15 cases. J Rheumatol 35:294–304Google Scholar
- 17.Giannouli S, Voulgarelis M, Zintzaras E, Tzioufas AG, Moutsopoulos HM (2004) Autoimmune phenomena in myelodysplastic syndromes: a 4-yr prospective study. Rheumatology 43:626–632Google Scholar
- 20.Jachiet V, Mekinian A, Carrat F, Grignano E, Retbi A, Boffa JJ, Ronco P, Rondeau E, Sellam J, Berenbaum F, Chazouillères O, Capron J, Alamowitch S, Chasset F, Frances C, Coppo P, Fain O, on behalf of French Network of systemic and immune disorders associated with hemopathies and cancer (MINHEMON) (2018) Autoimmune manifestations associated with lymphoma: characteristics and outcome in a multicenter retrospective cohort study. Leuk Lymphoma 59:1399–1405CrossRefGoogle Scholar
- 24.Liozon E, Loustaud V, Fauchais A-L, Soria P, Ly K, Ouattara B, Rhaiem K, Nadalon S, Vidal E (2006) Concurrent temporal (giant cell) arteritis and malignancy: report of 20 patients with review of the literature. J Rheumatol 33:1606–1614Google Scholar
- 36.Myklebust G, Wilsgaard T, Jacobsen BK, Gran JT (2002) No increased frequency of malignant neoplasms in polymyalgia rheumatica and temporal arteritis. A prospective longitudinal study of 398 cases and matched population controls. J Rheumatol 29:2143–2147Google Scholar
- 39.Institut national du cancer (2018) Les cancers en France, édition 2017Google Scholar