Death Rate and Causes of Death in Patients with Rheumatoid Arthritis

Abstract

Patients with rheumatoid arthritis, 500 males and 500 females, aged 40 years or over, and an age- and sex-matched control population were observed over a 3-year period. During the follow-up, 122 RA patients and 69 controls had died. The most common causes of death in RA patients were cardiovascular diseases (57 patients), renal failure (27 patients), infections (19 patients), and malignant neoplasms (11 patients); in the controls, the respective data are: cardiovascular diseases (35 people), malignant neoplasms (21 people), accidents (7 people), and infections (5 people).

On Inflammation and Cardiovascular Disease in Patients with Rheumatoid Arthritis

“…The study verified the increase of the overall death rate previously reported in several studies on patients with RA (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)44). In line with other reports, death was predicted by high age at disease onset and male sex (31,42,164) and cardiovascular event (165).…”

“…Two early studies reported a decreased death due to CVD (26,27) and the rather general intake of nonsteroid inflammatory drugs (NSAID) was suggested to provide a protection (45). However, there are now numerous reports on an increased cardiovascular mortality in RA (28,29,32,34,39,42,44). Some authors (29,39,44) have even reported higher mortality due to ischemic heart diseases (IHD) in RA compared to the general population while others have found the opposite (26,46) or equivalent rates (32,43).…”

“…Generally, hospital-based materials (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) reveal standardized mortality ratios (SMR) in the range of 1.3-2.5 but figures as high as 3.0 have been reported (39)(40). In population-based studies the excess death rates are somewhat lower (SMR 1.16-1.37), but still significantly higher than in controls (41,42), except for in one study (43).…”

Survival in rheumatoid arthritis

“…After reviewing all reports, a general association between death in RA and cardiovascular or malignant disease cannot be established. Most studies have found an increased mortality from infection (4,8,10,11,16), but the relative contributions of host factors and of therapy to deaths from sepsis are not clear.…”

Regression of the nephrotic syndrome in rheumatoid arthritis and amyloidosis treated with azathioprine

“…Renal involvement with amyloidosis has been a significant cause of death in patients with JRA (4,7) and with adult RA (5,6). In a recent review from Finland (8), the mortality rate due to amyloidosis in JRA decreased markedly in the 1980s compared with the period from 1969 to 1979.…”