Decrease in mortality for patients with rheumatoid arthritis

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Improve rheumatoid arthritis treatment options have led to lower mortality rates since 2000.
Improve rheumatoid arthritis treatment options have led to lower mortality rates since 2000.

Mortality rates for rheumatoid arthritis (RA) have decreased since 2000 due to better treatments that eradicate inflammation, according to research presented at the 2015 annual meeting of the American College of Rheumatology.

Diane Lacaille, MDCM, FRCPC, MHSc, professor in the Division of Rheumatology at the University of British Columbia and senior scientist at Arthritis Research Canada, and colleagues gathered data from physician visits and death certificates of 24,914 people with new-onset RA to determine whether treatments that lower inflammation had an effect on mortality rates.

“Since we now have more effective treatments for RA and since there has been a paradigm shift in our approach to treating RA, recommending early and aggressive treatment with [disease-modifying antirheumatic drugs] DMARDs with the aim of eradicating inflammation, we would hope that this new strategy of treating RA would lead to improvement in mortality,” said Dr Lacaille in a press release.

“Our study aimed to evaluate whether the risk of mortality in RA compared to the general population has improved over time, as we have been treating the inflammation of RA more effectively.”

Researchers also compiled information from a cohort of individuals without RA of similar age and gender. They divided participants between an “early” group, including those diagnosed between 1996 and 2000, and the “later” group of participants diagnosed between 2000 and 2006. Dr Lacaille and her team then analyzed the impact of new RA treatment options since the 2000s.

Over the course of the study, there were 2747 deaths among the participants with RA and 2123 deaths in the group without RA. The overall mortality rates were 24.43 per 1000 person-years for the participants with RA and 18.77 per 1000 person-years for participants without RA.

Dr Lacaille and her team assessed data from the subgroups and found that the participants diagnosed with RA before 2000 had a higher mortality rate when compared to the cohort without RA. The participants who were diagnosed after 2000 had a similar mortality rate when compared to the cohort without RA.

The findings were consistent after the researchers examined different causes of death (eg, cardiovascular disease and cancer). No significant difference was seen in mortality rates due to infection between the early and later groups.

“These findings should be reassuring to patients and clinicians,” Dr Lacaille stated. “It suggests that in recent years, as we have been more successful in treating rheumatoid arthritis and controlling inflammation, we have improved and possibly even closed the mortality gap between RA patients and the general population.”

Reference

  1. Lacaille D, Sayre EC, Abrahamowicz M. Declining deaths in people with rheumatoid arthritis suggest newer treatment strategies are hitting the mark. Presentation at: ACR/ARHP Annual Meeting, 2015. November 6-11, 2015; San Francisco, CA. http://www.newswise.com/articles/view/642620/?sc=sphr&xy=10011231. Abstract 1999.
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