Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Feb;76(2):408-413.
doi: 10.1136/annrheumdis-2015-209058. Epub 2016 Jun 23.

Improved survival in rheumatoid arthritis: a general population-based cohort study

Yuqing Zhang  1 , Na Lu  1 , Christine Peloquin  1 , Maureen Dubreuil  1 , Tuhina Neogi  1 , J Antonio Aviña-Zubieta  2 , Sharan K Rai  3 , Hyon K Choi  1   2   3
Affiliations

Improved survival in rheumatoid arthritis: a general population-based cohort study

Yuqing Zhang et al. Ann Rheum Dis. 2017 Feb.

Abstract

Objective: Mortality trends of rheumatoid arthritis (RA) are largely unknown over the past decade when new drugs and management strategies have been adopted to effectively treat RA.

Methods: Using The Health Improvement Network, an electronic medical record database representative of the UK general population, we identified patients with incident RA and up to five individuals without RA matched for age, sex and year of diagnosis between 1999 and 2014. The RA cohort was divided in two sub-cohorts based on the year of RA diagnosis: the early cohort (1999-2006) and the late cohort (2007-2014). We compared mortality rates, HRs (using a Cox proportional hazard model) and rate differences (using an additive hazard model) between RA and non-RA cohorts adjusting for potential confounders.

Results: Patients with RA diagnosed between 1999 and 2006 had a considerably higher mortality rate than their comparison cohort (ie, 29.1 vs 18.0 deaths/1000 person-years), as compared with a moderate difference in patients with RA diagnosed between 2007 and 2014 and their comparison cohort (17.0 vs 12.9 deaths/1000 years). The corresponding absolute mortality rate differences were 9.5 deaths/1000 person-years (95% CIs 7.5 to 11.6) and 3.1 deaths/1000 person-years (95% CI 1.5 to 4.6) and the mortality HRs were 1.56 (95% CI 1.44 to 1.69) and 1.29 (95% CI 1.17 to 1.42), respectively (both p values for interaction <0.01).

Conclusion: This general population-based cohort study indicates that the survival of patients with RA has improved over the past decade to a greater degree than in the general population. Improved management of RA and its associated comorbidities over recent years may be providing a survival benefit.

Keywords: DMARDs (biologic); Epidemiology; Rheumatoid Arthritis.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Graph showing the cumulative mortality of patients with rheumatoid arthritis (RA) and corresponding individuals without RA in early versus late cohorts (1999–2006 vs 2007–2014, respectively).
See this image and copyright information in PMC

References

    1. Dadoun S, Zeboulon-Ktorza N, Combescure C, et al. Mortality in rheumatoid arthritis over the last fifty years: systematic review and meta-analysis. Joint Bone Spine. 2013;80:29–33. - PubMed
    1. O’Dell JR. Therapeutic strategies for rheumatoid arthritis. N Engl J Med. 2004;350:2591–602. - PubMed
    1. Singh JA, Saag KG, Bridges SL, et al. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2016;68:1–25. - PubMed
    1. Smolen JS, Landewé R, Breedveld FC, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis. 2014;73:492–509. - PMC - PubMed
    1. Ward MM. Decreases in rates of hospitalizations for manifestations of severe rheumatoid arthritis, 1983–2001. Arthritis Rheum. 2004;50:1122–31. - PubMed