The life expectancy of patients with rheumatoid arthritis has not improved over the last four decades, despite innovations in treatment for the disease, finds a Mayo Clinic study.
Rheumatoid arthritis (RA) is an inflammatory disease that attacks the joints and can lead to substantial loss of mobility. But the disease is also an autoimmune disease and takes a progressive toll on all tissues in the body, including the heart, kidney and liver.
For years, the disease has been associated with a high risk of early death. Researchers wanted to know whether with the remarkable improvements in longevity in the general population, the trend had extended to patients with rheumatoid arthritis.
Dr. Sherine E. Gabriel from the Mayo Clinic in Rochester, Minn., led a study to evaluate trends in mortality in patients in whom rheumatoid arthritis was first diagnosed between 1955 and 2000 and who were followed until 2007. About 71 per cent of the subjects were women, with a mean age of 57.6 years when they were diagnosed.
The researchers compared these data with the expected mortality in the general population of individuals of the same age and sex. They found there was no significant difference in survival rates for rheumatoid arthritis patients.
Overall mortality among rheumatoid arthritis patients was 35 per cent higher than that of the general population, the authors report. The excess mortality was even more evident among female rheumatoid arthritis patients -- 49 per cent higher mortality than the rest of the population.
Cardiovascular deaths constitute at least half of the deaths in patients with rheumatoid arthritis.
"We found no evidence indicating that RA subjects experienced improvements in survival over the last four to five decades," said Gabriel.
"In fact, RA subjects did not even experience the same improvements in survival as their peers without arthritis, resulting in a worsening of the relative mortality in more recent years, and a widening of the mortality gap between RA subjects and the general population throughout time."
The reselts appear in the November 2007 issue of Arthritis & Rheumatism.
The researchers say the reasons for the widening mortality gap are unclear, and there is an "urgent need" to fully understand the reasons.
Gabriel said it is possible that the improvements in care for heart attacks and strokes that improved life expectancy in the general population have had the same benefits in patients with rheumatoid arthritis.
