Objective To determine prevalent comorbidities in cases with polymyalgia rheumatica (PMR) or giant cell arteritis (GCA) compared to matched controls.

Methods Nested, cross sectional case-control study within UK Biobank. Case status was defined as self-reported prior diagnosis of PMR or GCA. 10 controls per case were matched for age, sex, ethnicity and assessment centre. Associations with selected self-reported comorbidities were studied using conditional logistic regression.

Results Of PMR (n=1036) or GCA (n=102) cases, 72% were female, 98% white and 58% reported current use of glucocorticoids. Mean age was 63. At the time of the assessment visit, compared to controls, PMR/GCA cases were more likely to report poor general health and at least several days of low mood in the two past weeks. PMR was associated with hypothyroidism (odds ratio (OR) 1.34, 95% confidence interval (CI) 1.07-1.67) and ever-use of hormone replacement therapy (OR 1.26, CI 1.07-1.47). Regarding common comorbidities, PMR and GCA were both associated with hypertension (PMR: OR 1.21, CI 1.06-1.39; GCA: OR 1.86, CI 1.23-2.81) and cataract (PMR: OR 1.51, CI 1.19-1.93; GCA: OR 3.84, CI 2.23-6.60).

Additionally GCA was associated with depression (OR 3.05, CI 1.59-5.85). Neither were associated with diabetes.

Conclusion Participants with a history of PMR/GCA, including those not currently taking glucocorticoids, rated their health as poorer than matched controls,. Some previously-described disease associations (hypothyroidism and early menopause) were replicated. Hypertension and cataract, which can both be exacerbated by long-term glucocorticoid therapy, were over-represented in both diseases, particularly GCA.

Key messages

Comorbidity was common in individuals with self-reported prior diagnosis of PMR/GCA.

PMR/GCA were associated with poorer self-reported health than controls; GCA was associated with depression.

Hypertension and cataract were over-represented in PMR/GCA compared with controls but diabetes was not.

Chatzigeorgiou: None Barrett: None Taylor: None Elliot: None O'Sullivan: received honoraria from Roche in 2015 and UCB in 2022. Morgan: consultancy fees payable to her institution from Roche/Chugai, Sanofi/Regeneron, Glazo Smith Kline and AstraZeneca, outside the submitted work. Reports research and/or educational funding were received from Roche/Chugai and Kiniksa Pharmaceuticals, outside the submitted work. Mackie: consultancy on behalf of her institution for Roche/Chugai, Sanofi, AbbVie, AstraZeneca; Investigator on clinical trials for Sanofi, GSK, Sparrow; speaking/lecturing on behalf of her institution for Roche/Chugai, Vifor, UCB and Pfizer; patron of the charity PMRGCAuk. No personal remuneration was received for any of the above activities. Support from Roche/Chugai to attend EULAR2019 in person and from Pfizer to attend ACR Convergence 2021 virtually. This work was also supported by the MRC Treatment according to Response in Giant cEll arteritis (TARGET) Partnership award MR/N011775/1, the NIHR Leeds Biomedical Research Centre and NIHR Leeds Medicines and In Vitro Diagnostics Co-operative.

Chatzigeorgiou: PhD was supported by a Emma and Leslie Reid Scholarship from the University of Leeds Barrett: received salary support from the NIHR Leeds BRC Morgan: has received salary support from the MRC, NIHR Leeds BRC and NIHR Leeds Medtech and in vitro Diagnostics Co-operative; NIHR Senior Investigator Award Mackie: NIHR Clinician Scientist Fellowship NIHR-CS-012-016. Other authors: Costs for the data extract for this study were supported by a grant to Eoin O'Sullivan from the Fight for Sight Small Grants Scheme (Grant Award 1477/8). This study was also supported by the National Institute for Health Research (NIHR) Biomedical Research Centre and the NIHR Medtech and In vitro Diagnostics Co-operative. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

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Ethical approval for the UK Biobank study was granted by the North West Multi-Centre Research Ethics Committee, the Community Health Index Advisory Group and the Patient Information Advisory Group (Ref 11/NW/0382) and our study was approved by the UK Biobank ethical review committee (application 5237).

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