Rheumatoid arthritis

ACR: Mortality gap closing in RA

The mortality gap in rheumatoid arthritis patients compared with the general population is getting smaller, researchers have reported.

“It has been recognised for a decade or two that the risk of death is increased in RA compared with the general population, and this seems to be linked to inflammation,” said lead author Diane Lacaille a professor of rheumatology at the University of British Columbia who presented her findings at ACR2015.

“Because we now have more effective treatments for RA, there has been a paradigm shift in our approach to treating RA, recommending early and aggressive treatment with DMARDs with the aim of eradicating inflammation — we hoped this new strategy would lead to improvement in mortality,” she said.

The retrospective Canadian study of 24,914 incident cases of RA compared mortality rates for patients diagnosed between 1996 to 2000 with those diagnosed from 2001 to 2006.

During 112,431 person-years of follow-up among RA cases and 113,100 among controls, there were 2,747 and 2,123 deaths, respectively.

The all-cause mortality rates were 24.43 per 1,000 person-years among RA cases and 18.77 per 1,000 among controls.

Mortality was significantly increased in RA vs. controls in earlier, but not later, incident cohorts, for all-cause as well as cause-specific mortality, results showed.

In the age-adjusted models, a significant interaction between RA (vs. controls) and incident cohort (early vs. late) was found (p<0.001) for all-cause, CVD and cancer, but not infection (p=0.31).

“The mortality gap between RA and the general population present in people with RA onset on or before 2000 was no longer present in people with RA onset after 2000” the researchers concluded.


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