Mortality in early "sawtooth" treated rheumatoid arthritis patients during the first 8-14 years

Abstract

Objective: To describe mortality in a cohort of early RA patients treated from the onset with disease-modifying antirheumatic drugs (DMARDs) according to the 'sawtooth' strategy.

Patients and methods: A total of 135 early RA patients were followed up for 8-14 years or until death. Causes of death were checked on the death certificates and in patient files. Standardized mortality ratio (SMR) was calculated. Results. A total of 25 (14F, 11M) patients died during the 1422 person-years of follow-up. The SMR (95%CI) was 1.28 (0.83-1.89); 1.69 (0.92-2.82) for women and 0.98 (0.49-1.74) for men. In five cases death was closely related to RA. No one died from amyloidosis. Not a single death was caused by DMARDs in spite of extensive use of these drugs. Patient's age at the start was the only statistically significant predictor for death.

Conclusion: Despite active treatment with available DMARDs, RA seems still to be a fatal disease in a proportion of cases.