No excess long-term mortality risk in coeliac disease

Coeliac disease patients do not seem to suffer from significantly higher death risks in the long run, a recent study has found.

The researchers conducted a cohort study of 1,392 coeliac disease patients diagnosed from 1960 to 2000. The outcomes of overall and cause-specific mortalities were compared against a matched reference population of 4,177 healthy individuals, stratifying analysis according to demographic and disease characteristic subgroups.

Over a median follow-up of 26.5 years (up to 41 years), 376 coeliac patients and 1,155 controls died, resulting in corresponding mortality rates of 98.5 and 101.9 deaths per 10,000 person-years. Cox proportional hazards analysis found no significant difference in death risk between groups (hazard ratio [HR], 0.96, 95 percent confidence interval [CI], 0.85–1.08).

Similarly, patients with dermatitis herpetiformis had significantly better survival outlook than controls (HR, 0.87, 95 percent CI, 0.70–1.01). Other patient subgroups according to demographic or disease parameters did not yield significant mortality differences vs controls.

Nevertheless, cause-of-death analysis found that lymphoproliferative diseases, particularly non-Hodgkin’s and T-cell non-Hodgkin’s lymphoma, aggravated death risk, especially in coeliac disease patients diagnosed after 40 years of age. Diseases of the central nervous system likewise posed significant mortality risk for coeliac disease patients.

The present findings are reassuring, the researchers said, “as over half of the celiac disease patients in our series were diagnosed before the age of 40 years, thus having a long life expectancy ahead of them. It could also be interpreted as an indication of the beneficial effects of a long-lasting gluten-free diet.”