RESEARCH - Causes of death in patients with RA: comparison with siblings and matched OA controls

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J Rheumatol. 2007 Aug;34(8):1695-8.

Causes of death in patients with rheumatoid arthritis: comparison with

siblings and matched osteoarthritis controls.

Kumar N, Marshall NJ, Hammal DM, Pearce MS, L, Furniss SS,

Platt PN, DJ.

Musculoskeletal Unit, Freeman Hospital, Newcastle-upon-Tyne, UK.

OBJECTIVE: Survival of patients with rheumatoid arthritis (RA) is

reduced when compared to the general population. We assessed

differences in causes and age of death between patients with RA and

their siblings. Comparisons were also made with a control group of

subjects with lower limb osteoarthritis (OA). METHODS: A population of

257 patients with RA studied in 1991 was compared to 371 of their

same-sex siblings and 485 patients with hip and knee OA who were also

attending the department at this time. Death certificates were

obtained and compared. RESULTS: Among patients with RA, 54% (139/257)

were deceased, compared to 28% (105/371) of the siblings and 32%

(154/485) of OA patients (RA vs siblings or OA, p < 0.05). There were

more deaths due to ischemic heart disease (IHD) in both the RA and OA

groups compared to those expected; ratio observed/expected, 1.66 (95%

CI 1.01, 2.79) and 1.96 (95% CI 1.21, 3.25), respectively, but not for

siblings: observed/expected = 1.05 (95% CI 0.53, 2.08). There was a

significant deficit in cancer related deaths in RA patients,

observed/expected = 0.62 (95% CI 0.36, 1.03).

CONCLUSION: Significantly more patients with RA had died than in

either of the comparator populations. RA and OA patients died more

frequently of IHD than the siblings. The RA population had a 40%

reduced rate of cancer related deaths than expected and compared to

their siblings.

PMID: 17696284

http://www.ncbi.nlm.nih.gov/pubmed/17696284

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