Mortality in RA Same Today as In 1950s, Despite New Therapies

Rheumatoid arthritis patients have not experienced a decline in mortality, despite a dramatically increased life expectancy in the general population since the 1950s, according to investigators reporting on a cohort study.

In an interview, study investigator Dr. Hilal Maradit Kremers, of the Mayo Clinic in Rochester, Minn., said, “One assumes that since rheumatologists are trying to manage [RA] more aggressively, it must have a positive impact on mortality. … But all of our research is showing that the mortality in the RA patients did not change.”

In a population-based incidence cohort study, researchers looked at all 822 adult residents of Rochester in whom RA was first diagnosed between 1955 and 1995 and all adult residents of Olmsted County in whom RA was diagnosed between 1995 and 2000. The patients were followed up through medical records until their death or Jan. 1, 2007. The mean age at incidence was 58 years. Nearly three-quarters were women. The median length of follow-up was 11.7 years (Arthritis Rheum. 2007;56:3583–7).

RA patients' mortality was unchanged in each of the five study periods: from 1955 to 1964, 1965 to 1974, 1975 to 1984, 1985 to 1994, and 1995 to 2000. Female mortality hovered around 2.4 per 100 person-years, and male mortality was constant at about 2.5 per 100 person-years. In contrast, mortality in women in the Minnesota general population declined from 1.0 per 100 person-years in 1965 to 0.2 per 100 person-years in 2000. For men, the rate went from 1.2 to 0.3 per 100 person-years.

“Patients in whom RA was diagnosed in more recent years had a mortality rate similar to that of their peers in whom RA was diagnosed in the 1950s and 1960s. … The dramatic changes in therapeutic strategies for RA in the last 4–5 decades have not had a major impact on the excess mortality.”

Dr. Kremers reported no conflicts of interest in relation to this study.

Rheumatoid arthritis patients have not experienced a decline in mortality, despite a dramatically increased life expectancy in the general population since the 1950s, according to investigators reporting on a cohort study.

In an interview, study investigator Dr. Hilal Maradit Kremers, of the Mayo Clinic in Rochester, Minn., said, “One assumes that since rheumatologists are trying to manage [RA] more aggressively, it must have a positive impact on mortality. … But all of our research is showing that the mortality in the RA patients did not change.”

In a population-based incidence cohort study, researchers looked at all 822 adult residents of Rochester in whom RA was first diagnosed between 1955 and 1995 and all adult residents of Olmsted County in whom RA was diagnosed between 1995 and 2000. The patients were followed up through medical records until their death or Jan. 1, 2007. The mean age at incidence was 58 years. Nearly three-quarters were women. The median length of follow-up was 11.7 years (Arthritis Rheum. 2007;56:3583–7).

RA patients' mortality was unchanged in each of the five study periods: from 1955 to 1964, 1965 to 1974, 1975 to 1984, 1985 to 1994, and 1995 to 2000. Female mortality hovered around 2.4 per 100 person-years, and male mortality was constant at about 2.5 per 100 person-years. In contrast, mortality in women in the Minnesota general population declined from 1.0 per 100 person-years in 1965 to 0.2 per 100 person-years in 2000. For men, the rate went from 1.2 to 0.3 per 100 person-years.

“Patients in whom RA was diagnosed in more recent years had a mortality rate similar to that of their peers in whom RA was diagnosed in the 1950s and 1960s. … The dramatic changes in therapeutic strategies for RA in the last 4–5 decades have not had a major impact on the excess mortality.”

Dr. Kremers reported no conflicts of interest in relation to this study.

Rheumatoid arthritis patients have not experienced a decline in mortality, despite a dramatically increased life expectancy in the general population since the 1950s, according to investigators reporting on a cohort study.

In an interview, study investigator Dr. Hilal Maradit Kremers, of the Mayo Clinic in Rochester, Minn., said, “One assumes that since rheumatologists are trying to manage [RA] more aggressively, it must have a positive impact on mortality. … But all of our research is showing that the mortality in the RA patients did not change.”

In a population-based incidence cohort study, researchers looked at all 822 adult residents of Rochester in whom RA was first diagnosed between 1955 and 1995 and all adult residents of Olmsted County in whom RA was diagnosed between 1995 and 2000. The patients were followed up through medical records until their death or Jan. 1, 2007. The mean age at incidence was 58 years. Nearly three-quarters were women. The median length of follow-up was 11.7 years (Arthritis Rheum. 2007;56:3583–7).

RA patients' mortality was unchanged in each of the five study periods: from 1955 to 1964, 1965 to 1974, 1975 to 1984, 1985 to 1994, and 1995 to 2000. Female mortality hovered around 2.4 per 100 person-years, and male mortality was constant at about 2.5 per 100 person-years. In contrast, mortality in women in the Minnesota general population declined from 1.0 per 100 person-years in 1965 to 0.2 per 100 person-years in 2000. For men, the rate went from 1.2 to 0.3 per 100 person-years.

“Patients in whom RA was diagnosed in more recent years had a mortality rate similar to that of their peers in whom RA was diagnosed in the 1950s and 1960s. … The dramatic changes in therapeutic strategies for RA in the last 4–5 decades have not had a major impact on the excess mortality.”

Dr. Kremers reported no conflicts of interest in relation to this study.