Rheumatoid arthritis patients’ mortality unchanged
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The decline in mortality seen in the U.S. population over the past four decades has not extended to patients with rheumatoid arthritis, despite innovations in rheumatoid arthritis treatment, according to a report in the current issue of Arthritis & Rheumatism.
Rheumatoid arthritis is known to be associated with excess mortality, the authors explain, but whether survival in rheumatoid arthritis patients has improved over time has been unclear.
Dr. Sherine E. Gabriel and colleagues from the Mayo Clinic, Rochester, Minnesota evaluated trends in mortality in a population-based group of patients in whom rheumatoid arthritis was first diagnosed between 1955 and 2000 and who were followed until 2007. They compared these data with the expected mortality in the general population of individuals of the same age and sex.
Overall mortality among rheumatoid arthritis patients was 35 percent higher than that of the general population, the authors report, and excess mortality was even more evident among female rheumatoid arthritis patients (49 percent higher mortality) than among male rheumatoid arthritis patients (12 percent).
Throughout the five time periods examined, the mortality remained relatively constant for both female rheumatoid arthritis patients (2.4 per 100 people per year) and male patients (2.5 per 100 people per year).
In contrast, over the same period, the mortality in the general population declined from 1.0 deaths per 100 women and 1.2 per 100 men in 1965, to 0.2 deaths per 100 women and 0.3 per 100 men in 2000.
“Our findings indicate that rheumatoid arthritis patients have not experienced the same improvements in survival as the general population, and therefore the mortality gap between rheumatoid arthritis patients and individuals without rheumatoid arthritis has widened,” the authors maintain.
“Although the reasons for the widening mortality gap are unclear, cardiovascular deaths constitute at least half of the deaths in patients with rheumatoid arthritis, and it is possible that the cardiovascular interventions that improved life expectancy in the general population may not have had the same beneficial effects in patients with rheumatoid arthritis,” the researchers speculate.
There is an “urgent need” to fully understand the reasons for and implications of this trend so that appropriate strategies can be taken to close “the widening mortality gap that increasingly separates rheumatoid arthritis patients from the rest of the general population,” Gabriel and colleagues conclude.
SOURCE: Arthritis & Rheumatism, November 2007.
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