RESEARCH - Could accelerated aging explain the excess mortality in patients with seropositive RA?

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Arthritis & Rheumatism

Volume 62, Issue 2, Pages 378-382

Published Online: 7 Jan 2010

Could accelerated aging explain the excess mortality in patients with

seropositive rheumatoid arthritis?

S. Crowson, P. Liang, Terry M. Therneau, Hilal

Maradit Kremers, Sherine E. *

Mayo Clinic, Rochester, Minnesota

Dr. Maradit Kremers has received consulting fees, speaking fees,

and/or honoraria from Amgen (less than $10,000).

Funded by:

NIH; Grant Number: AR-30582

NIH National Institute of Arthritis and Musculoskeletal and Skin

Diseases; Grant Number: R01-R46849

USPHS

Abstract

Objective

To determine whether the mortality pattern in patients with

seropositive rheumatoid arthritis (RA) is consistent with the concept

of accelerated aging, by comparing the observed mortality rates in

patients with RA with the age-accelerated mortality rates from the

general population.

Methods

A population-based inception cohort of patients with seropositive RA

(according to the American College of Rheumatology 1987 criteria) was

assembled and followed up for vital status until July 1, 2008. The

expected mortality rate was obtained by applying the death rates from

the general population to the age, sex, and calendar year distribution

of the RA population. The observed mortality was estimated using

Kaplan-Meier methods. Acceleration factors for the expected mortality

were estimated in accelerated failure time models.

Results

A total of 755 patients with seropositive RA (mean age 55.6 years, 69%

women) were followed up for a mean of 12.5 years, during which 315

patients died. The expected median survival was age 82.4 years,

whereas the median survival of the RA patients was age 76.7 years.

Results of statistical modeling suggested that, in terms of mortality

rates, patients with RA were effectively 2 years older than actual age

at RA incidence, and thereafter the patients underwent 11.4 effective

years of aging for each 10 years of calendar time.

Conclusion

The overall observed mortality experience of patients with

seropositive RA is consistent with the hypothesis of accelerated

aging. The causes of accelerated aging in RA deserve further

investigation.

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