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Mortality in rheumatoid arthritis
R A Myllykangas-Luosujärvi1, K Aho, H A Isomäki
1Rheumatism Foundation Hospital, Heinola, Finland.
Seminars in Arthritis and Rheumatism
|December 1, 1995
Summary
Rheumatoid arthritis (RA) patients face significantly reduced life expectancy, with higher mortality from infections, kidney, and gastrointestinal issues. Cardiovascular mortality causes in RA patients require further investigation.
Area of Science:
- Rheumatology
- Epidemiology
- Public Health
Background:
- Rheumatoid arthritis (RA) is associated with a substantially reduced life expectancy.
- Standardized mortality ratios in RA patients range from 1.13 to 2.98.
- Both rheumatoid factor (RF)-positive and a subgroup of RF-negative RA patients exhibit adverse prognoses.
Purpose of the Study:
- To analyze the mortality patterns and causes of death in patients with rheumatoid arthritis.
- To investigate the factors contributing to excess mortality in RA.
- To understand the impact of RA on life expectancy.
Main Methods:
- Review of existing clinical and population-based studies on RA mortality.
- Analysis of standardized mortality ratios.
- Examination of causes of death, including infection, renal, gastrointestinal, and cardiovascular diseases.
Main Results:
- Excess mortality is observed in RA patients, particularly RF-positive cases.
- Infection and renal disease mortality likely reflect severe RA disease.
- Gastrointestinal mortality is often treatment-related, while cardiovascular mortality causes remain unclear.
- Pre-illness factors like smoking may influence RA and cardiovascular disease susceptibility.
Conclusions:
- Rheumatoid arthritis significantly impacts life expectancy.
- Excess mortality in RA is complex, influenced by disease severity, treatment, and potentially rheumatoid factor and pre-illness factors.
- Further research is needed to elucidate the causes of cardiovascular mortality and the effect of treatments on overall mortality in RA.