Abhishek A, et al. - A scrutiny was performed of the temporal trends in all-cause and cause-specific mortality in individuals with rheumatoid arthritis (RA). Data illustrated a prominent decline in the mortality rate in RA cases incident after the year 2006. A trend was brought to light towards a decline in death from cardiovascular diseases, which could be attributed to improved management of RA. Nevertheless, RA displayed a persistent link with higher mortality rates, even in cohorts from recent years.

Methods

• Data was cumulated from the Clinical Practice Research Datalink.
• Experts selected incident RA cases and 4 age-, sex- and general practice-matched controls from at-risk cohorts for each calendar year and followed-up for up to 5 years.
• This was followed by an estimation of the mortality rates and 95% CIs.
• In order to determine associations, the Cox proportional hazard ratios (HRs) were measured, which were adjusted for covariates.
• With the aid of the Joinpoint regression program, researchers analyzed the temporal trend in mortality.
• Data management and analysis were carried out using Stata version 14.

Results

• The enrollment comprised of 21,622 cases with incident RA and 86,488 controls.
• It was revealed that the mortality rate of RA cases and controls was 26.90 (95% CI 25.87, 27.97) and 18.92 (18.48, 19.36)/1,000 person-years, respectively.
• No notable variation was determined in the mortality rate among RA cases between 1990 and 2004, however, a decrease was found by 7.7%/year between 2005 and 2009.
• Nevertheless, a steady improvement was illustrated in the mortality rate in controls by 2.2%/year between 1990 and 2009.
• Findings exhibited that RA was related to a 32% excess risk of mortality in the entire cohort [adjusted HR 1.32 (95% CI 1.26, 1.38)].
• After 2006, this was only 15% in cases incident [adjusted HR 1.15 (95% CI 1.03, 1.29)].
• Likewise, a decrease was disclosed in the HR of death due to cardiovascular diseases among cases incident in recent years.