Mortality in rheumatoid arthritis patients with disease onset in the 1980s

Objective-Several previous studies have shown increased mortality in rheuma toid arthritis (RA) patients. This study investigated if this was true also for patients with disease onset in the 1980s. Patients and methods-The study group comprised 183 patients (67 men and 116 women) with definite RA participating in an ongoing prospective study. Mea n age at onset of disease was 51 years, and mean duration of joint symptoms at inclusion was 11 months. The patients were included between 1985-89. Se venty five per cent of the patients were rheumatoid factor (RF) positive, 8 5% carried the shared epitope, and 90% became erosive. By 1 September 1997 the number and causes of death, obtained from the death certificates, were recorded. Standardised mortality ratio (SMR) was calculated, comparing the observed number of deaths in the cohort with the expected number of deaths in the general population in the same area, age and sex matched. The predic tive values of demographics, genotype, RF status, and clinical data at base line were estimated using the Cox proportional hazards regression model. Results-Eighteen patients (11 men and 7 women) had died compared with 20 ex pected deaths. SMR with 95% confidence intervals was 87 (53, 136). There wa s no significant increase in the number of deaths at any time during follow up for either sex. RA was not the main cause of death in any of the cases. By reading the patient charts two cases were found where RA or its treatme nt could have contributed to death. No RA related variable contributed sign ificantly to an increased risk of death. Conclusion-There was no increased mortality during the first 8-13 years of disease in this group of patients who developed RA in the 1980s.