Trends in health care of patients with vasculitides, including giant cell arteritis, Takayasu arteritis, ANCA-associated vasculitis and Behçet's disease: cross-sectional data of the German National Database 2007-2021

Rheumatol Int. 2024 Mar;44(3):497-507. doi: 10.1007/s00296-023-05508-x. Epub 2024 Jan 5.

Abstract

The aim of this study is to present the current care situation of patients with giant cell arteritis (GCA), Takayasu arteritis (TAK), ANCA-associated vasculitis (AAV) and Behçet's disease (BD). Trends over the last 15 years will reflect improvements and remaining deficits in the management of vasculitides. Consecutive cross-sectional data from patients with vasculitides from the German National Database (NDB) of the Collaborative Arthritis Centres between 2007 and 2021 were included. Medication, physician- and patient-reported outcomes on disease activity and disease burden, inpatient stays and occupational participation are compared for different vasculitis entities and over time. Employment rates were compared to German population rates. Between 502 and 854 vasculitis patients were annually documented. GCA and AAV were the most common vasculitides. Median disease duration ranged from 2 to 16 years. Over the years, glucocorticoids decreased in proportion and dose, most markedly in GCA and TAK, while biologic therapies increased up to 27%. Physicians rated disease activity as low for the vast majority of patients, while patients-reported moderate outcomes in many dimensions. PROs remained largely unchanged. The proportion of employed patients (< 65 years) increased from 47 to 57%. In recent years, biologics are increasingly used in patients with vasculitides, while glucocorticoids decreased significantly. PRO's have not improved. Work participation increased but remains lower than that in the German population.

Keywords: Behçet’s disease; Giant cell arteritis; Granulomatosis with polyangiitis; Health care; Microscopic polyangiitis; Takayasu arteritis.

MeSH terms

  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis* / drug therapy
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis* / epidemiology
  • Behcet Syndrome* / diagnosis
  • Behcet Syndrome* / drug therapy
  • Behcet Syndrome* / epidemiology
  • Cross-Sectional Studies
  • Delivery of Health Care
  • Giant Cell Arteritis* / drug therapy
  • Giant Cell Arteritis* / epidemiology
  • Giant Cells
  • Glucocorticoids / therapeutic use
  • Humans
  • Takayasu Arteritis* / drug therapy
  • Takayasu Arteritis* / epidemiology

Substances

  • Glucocorticoids