Mortality in patients with rheumatoid arthritis treated actively from the time of diagnosis

Peltomaa, Ritva; Paimela, Leena; Kautiainen, Hannu; Leirisalo‐Repo, Marjatta

doi:10.1136/ard.61.10.889

Cited by 65 publications

(41 citation statements)

References 34 publications

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“…In our previously published results, including patients from the present cohort, the mortality rate was neither increased after 8-13 nor after 13-18 years (SMR 0.87 and 1.33, respectively) compared to age-and sex-matched controls (18,19). No excess mortality was found in another study where actively treated RA patients were followed up for 7-14 years after diagnosis (20). A recently published study including all incident cases of RA with disease onset in the 2000s in Finland reported no increased risk of death (21).…”

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confidence: 65%

“…A recently published study including all incident cases of RA with disease onset in the 2000s in Finland reported no increased risk of death (21). In a Dutch inception cohort study including > 600 early RA patients, there was no increased mortality during the first 10 years (22) but thereafter the mortality rate increased during the years 11-23 of follow-up (23).Possible predictors of excess mortality have been examined in several studies.High disease activity at the onset was found to be associated with increased mortality in some reports (3,20,24). Other reported risk factors for increased mortality are the presence of extra-articular features (3, 17), high age, male sex, rheumatoid factor positivity (3, 5, 23), and functional status (2, 3).…”

mentioning

confidence: 96%

“…High disease activity at the onset was found to be associated with increased mortality in some reports (3,20,24). Other reported risk factors for increased mortality are the presence of extra-articular features (3,17), high age, male sex, rheumatoid factor positivity (3,5,23), and functional status (2,3).…”

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confidence: 96%

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Long-term mortality rate in rheumatoid arthritis patients with disease onset in the 1980s

Kapetanovic

Lindqvist

Geborek

et al. 2011

Scandinavian Journal of Rheumatology

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Objective: To investigate the mortality rate and possible early predictive factors of mortality after 19-23 years in a cohort of patients with rheumatoid arthritis (RA) followed prospectively from disease onset. Patients and methods:A community-based cohort of 183 patients (63% female) with RA and disease duration < 2 years was recruited [1985][1986][1987][1988][1989]. The patients were followed yearly from diagnosis until death or 31 December 2008. Mean age and mean duration of symptoms (range) at diagnosis were 52 (18-78) years and 11 (0-24) months, respectively. Death certificates were obtained from the Swedish Cause of Death Register and causes of death coded by the International Classification of Diseases (ICD-10). Death rates of RA patients were compared to those of age-and sex-matched controls. Possible predictors of mortality were analysed using a Cox regression model. Results:By 31 December 2008, 69 patients (37 women and 32 men) had died. The standardized mortality ratio (SMR) was 1.23 [95% confidence interval (CI) 0.97-1.55] and p < 0.09. Older age, male sex, smoking, and the presence of cardiovascular disease (CVD) at RA diagnosis were identified as early predictors of mortality. CVD was the most common cause of death (46%), followed by malignancies (29%) and infections (13%). RA was not stated as the direct cause of death in any patient and was mentioned among underlying causes in only 16/69 (23%) patients. Conclusion:Mortality rate after 19-23 years of disease duration in this cohort of patients with disease onset in the 1980s was not significantly increased compared to age-and sexmatched controls. No RA disease-related factor predicted mortality.Rheumatoid arthritis (RA) is a chronic inflammatory disease commonly associated with joint destruction, disability, and increased co-morbidity. The issue of premature mortality in patients with RA has been addressed in numerous studies. The first study reporting an increased mortality in patients with RA compared to controls was published in 1953 (1), and was followed by several reports confirming these findings (2-9). In recent decades the approach to treatment of RA and treatment strategies in RA has changed dramatically. Early treatment with disease-modifying anti-rheumatic drugs (DMARDs) and the availability of biological remedies have led to better control of disease activity and decreased disability (10)(11)(12)(13)(14). However, in a population-based analysis of trends over four decades published in 2003, an increased mortality rate [standardized mortality ratio (SMR) of 1.27] in RA patients was found (6). Overall mortality in the general population was shown to decrease over 4-5 decades but mortality rates in RA remained relatively constant, resulting in a widening of the mortality gap (7). A recently published review of > 200 studies on mortality in RA reported lower SMRs in studies of inception cohorts compared to non-inception cohorts over 60 years (median SMRs of 1.2-1.3 and 1.6-1.7, respectively) (15). Krause et al (16) found that a sufficien...

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confidence: 65%

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confidence: 96%

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Long-term mortality rate in rheumatoid arthritis patients with disease onset in the 1980s

Kapetanovic

Lindqvist

Geborek

et al. 2011

Scandinavian Journal of Rheumatology

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“…Upala i autoimunost su povezani sa povećanim kardiovaskularnim rizikom kod oboljelih od RA [7][8][9][10][11]. Nepovoljni prognostički faktori uključuju muški pol, nizak socioekonomski status, stariji uzrast, visoku aktivnost bolesti, povećane markere zapaljenja i vezani komorbiditet [12].…”

Section: Uvodunclassified

Komorbiditeti kod oboljelih od reumatoidnog artritisa

Radić

Prodanović

Kovačević

et al. 2016

Biomedicinska istraž.

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Kratak sadržajUvod. Reumatoidni artritis je sistemsko, autoimunsko oboljenje koje dovodi do deformacija i destrukcija zglobova, smanjujući radnu sposobnost oboljelog i značajno utičući na kvalitet života. Bolest u oko 80% bolesnika počinje postepeno, a klinički se ispolji nakon neke infekcije, tjelesne ili psihičke traume, ili porođaja. Komorbiditeti (pridružena oboljenja) nisu rijetki kod bolesnika sa reumatoidnim artritisom, pa prosječno kod pojedinog bolesnika sa reumatoidnim artritisom postoji 1,6 komorbiditeta. Cilj istraživanja je ispitivanje učestalosti pridruženih bolesti kod bolesnika sa reumatoidnim artritisom, kao i promjene te učestalosti tokom jednogodišnjeg praćenja.Metode. Istraživanjem je obuhvaćeno 50 bolesnika sa reumatoidnim artritisom koji su liječeni ambulantno i hospitalno na području Hercegovine. Dijagnoza je postavljena prema revidiranim kriterijumima Američkog udruženja reumatologa iz 1987. godine.Rezultati. Među bolesnicima liječenim od reumatoidnog artritisa bilo je više žena (74%) nego muškaraca (20%). Prosječna starosna dob žena bila je 55,6±12,6 godina, a muškaraca 58,1±11,2 godine. Najveći broj ispitanika (26%) oboljelih od reumatoidnog artritisa imalo je kardiovaskularne bolesti (hipertenzija, angina pektoris, valvularne bolesti srca), 12% ispitanika bolesti endokrinog sistema (diabetes mellitus i bolesti štitaste žlijezde) i 4% ispitanika bolesti gastrointestinalnog trakta. Tokom praćenja povećavala se učestalost svih komorbiditeta.Zaključak. Visok procenat bolesnika sa reumatoidnim artritisom ima pridružena oboljenja među kojima svojom učestalošću prednjače bolesti kardiovaskularnog sistema.

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“…La ricerca sistematica della letteratura non ha permesso di reperire nessuno studio di qualità sufficiente da poter essere analizzato. Infatti, i pazienti affetti da infezione severa vengono esclusi dagli studi clinici e persi al follow up, per cui è possibile ottenere dati di prevalenza ma non di strategia terapeutica (24)(25)(26)(27); nessuno studio mette a confronto tali pazienti con gruppi di controllo (28); in molti degli studi analizzati il MTX non è assunto in monoterapia (29)(30). L'analisi di vari studi confrontanti MTX e farmaci biologici, ha, però, permesso di calcolare una prevalenza generale per infezioni severe variabile dall'1 al 4% nei gruppi in monoterapia con MTX (31)(32)(33)(34)(35)(36)(37).…”

Section: Raccomandazione 13unclassified

Italian consensus on the recommendations about the use of methotrexate for the treatment of rheumatic diseases with a focus on rheumatoid arthritis: results from the “3E initiative”

Leonardis¹,

Alivernini²,

Bonacci³

et al. 2011

Reumatismo

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Nonostante il frequente utilizzo, la nota efficacia e la grande esperienza accumulata in più di venti anni dalla sua introduzione nella pratica clinica linee-guida inerenti al suo impiego in Reumatologia non sono state sinora pubblicate. L'approccio dei reumatologi in riferimento a diversi aspetti del suo utilizzo rimane quindi a tutt'oggi molto eterogeneo, empirico e basato sull'esperienza personale. L'iniziativa "3E (Evidence, Expertise, Exchange) in Rheumatology" per l'anno 2007-2008 è stata dedicata alla formulazione di un set di raccomandazioni sull'uso del MTX nelle malattie reumatiche, e in particolare nell'AR. L'iniziativa "3E in Rheumatology" è nata col fine di definire e divulgare, sia a livello internazio-INTRODUZIONE I l methotrexate (MTX) è il DMARD (diseasemodifying antirheumatic drug) più utilizzato per il trattamento dell'artrite reumatoide (AR) ed è prescritto anche a pazienti affetti da altre malattie reumatiche (1, 2). Reumatismo, 2010; 62(1)

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Mortality in patients with rheumatoid arthritis treated actively from the time of diagnosis

Cited by 65 publications

References 34 publications

Long-term mortality rate in rheumatoid arthritis patients with disease onset in the 1980s

Long-term mortality rate in rheumatoid arthritis patients with disease onset in the 1980s

Komorbiditeti kod oboljelih od reumatoidnog artritisa

Italian consensus on the recommendations about the use of methotrexate for the treatment of rheumatic diseases with a focus on rheumatoid arthritis: results from the “3E initiative”

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