Rheumatoid arthritis: lower mortality in more recent cohort of Canadian patients

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Takeaway

  • Mortality among patients with rheumatoid arthritis (RA) improved over time in a Canadian study.

Why this matters

  • Better treatment might be improving RA survival.

Study design

  • Population cohort study of all new patients with RA diagnosed in British Columbia between 1996 and 2006, matched with control patients from the general population by sex, age, and index year (24,914 in both groups), to compare 5-y all-cause and disease-specific mortality.
  • Subcohorts: RA onset in 1996-2000 and RA onset in 2001-2006.
  • Funding: Canadian Institute for Health Research.

Key results

  • At baseline, patients with RA had higher incidence of COPD, cardiovascular disease (CVD), and hospitalizations (P<.001 for all), but no significant difference in overall comorbidity.
  • In an age adjusted calculation, there were reductions from the earlier to the later subcohort in all-cause (P<.001), CVD (P<.001), and cancer (P=.002) deaths, but not infection deaths (P=.097).
  • Earlier subcohort patients with RA had lower survival than control patients for all-cause, CVD, and cancer deaths (log rank test, P<.01).
  • The later subcohort did not have significantly different all-cause (P=.695), cancer (P=.127), or CVD (P=.583) mortality rates compared with the control population.

Limitations

  • Cause of outcomes cannot be determined.