Mortality following new-onset Rheumatoid Arthritis: has modern Rheumatology had an impact?
- 1 January 2018
- journal article
- research article
- Published by BMJ in Annals Of The Rheumatic Diseases
- Vol. 77 (1), 85-91
- https://doi.org/10.1136/annrheumdis-2017-212131
Abstract
Objective To investigate if, and when, patients diagnosed with rheumatoid arthritis (RA) in recent years are at increased risk of death. Methods Using an extensive register linkage, we designed a population-based nationwide cohort study in Sweden. Patients with new-onset RA from the Swedish Rheumatology Quality Register, and individually matched comparators from the general population were followed with respect to death, as captured by the total population register. Results 17 512 patients with new-onset RA between 1 January 1997 and 31 December 2014, and 78 847 matched general population comparator subjects were followed from RA diagnosis until death, emigration or 31 December 2015. There was a steady decrease in absolute mortality rates over calendar time, both in the RA cohort and in the general population. Although the relative risk of death in the RA cohort was not increased (HR=1.01, 95% CI 0.96 to 1.06), an excess mortality in the RA cohort was present 5 years after RA diagnosis (HR after 10 years since RA diagnosis=1.43 (95% CI 1.28 to 1.59)), across all calendar periods of RA diagnosis. Taking RA disease duration into account, there was no clear trend towards lower excess mortality for patients diagnosed more recently. Conclusions Despite decreasing mortality rates, RA continues to be linked to an increased risk of death. Thus, despite advancements in RA management during recent years, increased efforts to prevent disease progression and comorbidity, from disease onset, are needed.Funding Information
- Vetenskapsrådet
- Stockholms Läns Landsting
- Karolinska Institutet
- Hjärt-Lungfonden
- Stiftelsen för Strategisk Forskning
This publication has 17 references indexed in Scilit:
- Mortality Trends in Patients With Early Rheumatoid Arthritis Over 20 Years: Results From the Norfolk Arthritis RegisterArthritis Care & Research, 2014
- Incidence of Rheumatoid Arthritis in Sweden: A Nationwide Population‐Based Assessment of Incidence, Its Determinants, and Treatment PenetrationArthritis Care & Research, 2013
- Mortality in rheumatoid arthritis over the last fifty years: Systematic review and meta-analysisJoint Bone Spine, 2012
- Risk of incident cardiovascular events in patients with rheumatoid arthritis: a meta-analysis of observational studiesAnnals Of The Rheumatic Diseases, 2012
- Nationwide prevalence of rheumatoid arthritis and penetration of disease-modifying drugs in SwedenAnnals Of The Rheumatic Diseases, 2010
- Epidemiology of Rheumatoid Arthritis: Rheumatoid Arthritis and MortalityCurrent Rheumatology Reports, 2010
- Excess mortality emerges after 10 years in an inception cohort of early rheumatoid arthritisArthritis Care & Research, 2010
- The Swedish personal identity number: possibilities and pitfalls in healthcare and medical researchEuropean Journal of Epidemiology, 2009
- Anti-CCP antibody test predicts the disease course during 3 years in early rheumatoid arthritis (the Swedish TIRA project)Annals Of The Rheumatic Diseases, 2004
- The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritisArthritis & Rheumatism, 1988