In the JournalsPerspective

Study: RA-attributed deaths declined from 1987 to 2011

From 1987 to 2011, deaths with rheumatoid arthritis as an underlying cause declined by 9.2%, according to an WHO database analysis of 31 countries in North America, Europe and Australia.

“It has been suggested that changes in the management of [rheumatoid arthritis] RA toward early and aggressive treatment with disease-modifying antirheumatic drugs and subsequent biologic therapies has led to better health status and lower mortality for most people with RA over time,” Aliasghar A. Kiadaliri, PhD, at Lund University in Sweden, and colleagues wrote. “In addition, it has been suggested that RA may be becoming a milder disease in general. Furthermore, large reductions in prevalence of smoking in people with RA over recent decades, improvements in diagnosis, increased public awareness of RA and general improvements in cardiovascular mortality might also partially explain the observed declining trend in our study.”

Ali Kiadaliri
Aliasghar A. Kiadaliri

Investigators found a 9.2% reduction in RA-related deaths from 9,281 in 1987 to 8,428 in 2011. The 3-year mean age-standardized RA mortality rate declined by 48.2% from 1987 to 2011, with increases found only in Israel, Croatia and Slovenia. The between-country disparity also dropped from 16 deaths per million person-years to 1.8 deaths in the study period.

From 1987 to 2011, 219,189 people died with rheumatoid arthritis (RA), which represented 22.2% of musculoskeletal disorder deaths and 0.1% of all deaths. Investigators also found the proportion of RA-related deaths of musculoskeletal deaths dropped from 30% to 17.7% in the study period.

“Although increased survival with rheumatoid arthritis is great news, it might lead to a greater share of our aging population having the disease and in need of health services,” Kiadaliri said in a press release. “This needs to be accounted for in health care planning.” – by Will A. Offit

Disclosures: The researchers report they received support by the Swedish Research Council, the Crafoord Foundation, the Greta and Johan Kocks Foundation and the Faculty of Medicine at Lund University, as well as Governmental Funding of Clinical Research within National Health Service and Region Skåne.

Reference:

http://newsroom.wiley.com/press-release/all-journals-and-research/studies-examine-rheumatoid-arthritis-patients-prognosis

From 1987 to 2011, deaths with rheumatoid arthritis as an underlying cause declined by 9.2%, according to an WHO database analysis of 31 countries in North America, Europe and Australia.

“It has been suggested that changes in the management of [rheumatoid arthritis] RA toward early and aggressive treatment with disease-modifying antirheumatic drugs and subsequent biologic therapies has led to better health status and lower mortality for most people with RA over time,” Aliasghar A. Kiadaliri, PhD, at Lund University in Sweden, and colleagues wrote. “In addition, it has been suggested that RA may be becoming a milder disease in general. Furthermore, large reductions in prevalence of smoking in people with RA over recent decades, improvements in diagnosis, increased public awareness of RA and general improvements in cardiovascular mortality might also partially explain the observed declining trend in our study.”

Ali Kiadaliri
Aliasghar A. Kiadaliri

Investigators found a 9.2% reduction in RA-related deaths from 9,281 in 1987 to 8,428 in 2011. The 3-year mean age-standardized RA mortality rate declined by 48.2% from 1987 to 2011, with increases found only in Israel, Croatia and Slovenia. The between-country disparity also dropped from 16 deaths per million person-years to 1.8 deaths in the study period.

From 1987 to 2011, 219,189 people died with rheumatoid arthritis (RA), which represented 22.2% of musculoskeletal disorder deaths and 0.1% of all deaths. Investigators also found the proportion of RA-related deaths of musculoskeletal deaths dropped from 30% to 17.7% in the study period.

“Although increased survival with rheumatoid arthritis is great news, it might lead to a greater share of our aging population having the disease and in need of health services,” Kiadaliri said in a press release. “This needs to be accounted for in health care planning.” – by Will A. Offit

Disclosures: The researchers report they received support by the Swedish Research Council, the Crafoord Foundation, the Greta and Johan Kocks Foundation and the Faculty of Medicine at Lund University, as well as Governmental Funding of Clinical Research within National Health Service and Region Skåne.

Reference:

http://newsroom.wiley.com/press-release/all-journals-and-research/studies-examine-rheumatoid-arthritis-patients-prognosis

    Perspective

    Eric Matteson

    • This study demonstrates a reduction in rheumatoid arthritis-related deaths across a spectrum of mostly Western countries, with one large Asian country, Japan, included in the survey during a recent 25-year period. This observation generally reflects an overall improvement in RA-related outcomes as reflected in less need for orthopedic surgery, less disease activity and some improvement in comorbidities, such as heart disease, reported in various cohorts in recent years. 

      Despite differences in health systems, differences in disease management and disease-related comorbidities and doubtless major differences in reporting of mortality causation between countries, the decline in RA-related mortality, while uneven across countries surveyed, is in general in the same direction. Further studies to understand factors related to the decline in RA-related mortality will be useful for clinicians and health policy experts.

      • Eric Matteson, MD
      • Rheumatologist and professor of medicine at Mayo Clinic
        Rochester, Minnesota
    • Disclosures: Matteson reports no relevant financial disclosures.