THE MORTALITY OF RHEUMATOID VASCULITIS COMPARED WITH RHEUMATOID-ARTHRITIS

Objective. To determine whether the mortality of patients with rheumat oid vasculitis (RV) is increased in comparison with that of patients w ith rheumatoid arthritis (RA). Methods. The mortality of all RV patien ts identified In 1980-1992 (n = 61) was compared with that of 244 RA c ontrols matched for the year the diagnosis was made in the RV cases. H azard ratios (HR) of death were calculated with a multivariate surviva l analysis, adjusting for age, sex, comorbidity, treatment, and parame ters of RA severity. Results. The unadjusted risk of death (HR) in RV patients compared with RA controls was 1.65 (95% confidence interval [ 95% CI] 1.05-2.58). After adjustment for prognostic factors, the HR wa s reduced to 1.26 (95% CI 0.79-2.01), mainly due to removal of the eff ects of age and sex. No excess mortality was seen in RV patients with severe organ involvement when compared with RV patients without severe organ involvement, although the former patients were treated more oft en with cytostatic and immunosuppressive drugs. Infection was the main cause of death in the RV patients, and cardiovascular disease in the RA controls. Vasculitis was reported as the cause of death in only 1 R V patient. Conclusion. After allowance for general risk factors such a s age and sex, there remains only a slight excess mortality in RV pati ents compared with RA controls.