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Mortality in Wegener's granulomatosis: a bimodal pattern

Luqmani, Raashid, Suppiah, Ravi, Edwards, Christopher J., Phillip, Rhodri, Maskell, Joe, Jayne, David, Morishita, Kimberly and Arden, Nigel (2011) Mortality in Wegener's granulomatosis: a bimodal pattern Rheumatology, 50, (4), pp. 697-702. (doi:10.1093/rheumatology/keq351). (PMID:21112869).

Record type: Article


Objective. To characterize the long-term mortality in patients with WG compared with matched population-based controls.

Methods. We used data from the General Practice Research Database, which contains the computerized records of 6.25 million patients and is representative of the population of the UK. We identified all subjects with a new diagnosis of WG in the period 1989–2004, and for each case, compared mortality with 10 controls matched for age, gender and practice.

Results. We identified 255 patients with a new diagnosis of WG (mean age 58.1 years, range 9–90 years, 47% females) and 2546 controls (mean age 58.1 years, range 9–89 years, 47% females). Mean follow-up was 6.4 years. The mortality for patients with WG was significantly increased during the first year after diagnosis [HR 9.0 (95% CI 5.8, 13.9)], especially for those ?65 years of age [HR 19.9 (95% CI 8.8, 44.9)]. The excess mortality was less marked after the first year: 1–5 years [HR 1.68 (95% CI 1.08, 2.60)], 5–10 years [HR 2.41 (95% CI 1.43, 4.07)], but started to increase by 10–15 years [HR 4.4 (95% CI 2.0, 9.8)]. The Kaplan–Meier survival curve showed an increase in mortality after 8 years.

Conclusions. Despite current therapy, patients with WG have a 9-fold increased risk of death in the first year of disease, attributed to infection, active vasculitis and renal failure. Between 1 and 8 years the risk is at its lowest, although higher than the control population. There is an increased mortality from 8 years onwards that remains unexplained.

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Published date: April 2011
Keywords: wegener’s granulomatosis, mortality, vasculitis, general practice research database, cyclophosphamide, corticosteroids, prednisolone
Organisations: Primary Care & Population Sciences


Local EPrints ID: 181799
ISSN: 1462-0324
PURE UUID: d697f41a-9e1b-4f50-aefc-d902688d88a4

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Date deposited: 18 Apr 2011 10:31
Last modified: 18 Jul 2017 11:58

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Author: Raashid Luqmani
Author: Ravi Suppiah
Author: Rhodri Phillip
Author: Joe Maskell
Author: David Jayne
Author: Kimberly Morishita
Author: Nigel Arden

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