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

Objective. To describe mortality in a cohort of early RA patients treated f rom 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 cer tificates and in patient files. Standardized mortality ratio (SMR) was calc ulated. Results. A total of 25 (14F, 11M) patients died during the 1422 person-year s 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. Tn five cases death was closely r elated to RA. No one died From amyloidosis. Not a single death was caused b y DMARDs in spite of extensive use of these drugs. Patient's age at the sta rt 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.