Ann Rheum Dis 2000;59:954-958 ( December )

Extended report

No increased mortality in patients with rheumatoid arthritis: up to 10 years of follow up from disease onset E J A Kroot^a, M A van Leeuwen^b, M H van Rijswijk^b, M L L Prevoo^a, M A Van 't Hof^a, L B A van de Putte^a, P L C M van Riel^a

^a Department of Rheumatology, University Medical Centre Nijmegen, Nijmegen, The Netherlands, ^b Department of Rheumatology, University Hospital Groningen, Groningen, The Netherlands

Correspondence to: Dr E J A Kroot, Department of Rheumatology, University Medical Centre Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands E.Kroot{at}reuma.azn.nl

Accepted for publication 18 August 2000

OBJECTIVETo investigate mortality, functional capacity, and prognostic factors for mortality in an inception cohort of patients with recently diagnosed RA followed up for up to 10 years.
METHODSThe observed mortality of this inception cohort with recently diagnosed RA, was analysed in relation to the expected mortality, calculated with the aid of life tables of the general population of the Netherlands (matched for age and sex). Functional capacity was measured by the Health Assessment Questionnaire. Prognostic factors for mortality were analysed multivariately by the Cox proportional hazards model.
RESULTSBetween January 1985 and April 1997, 622 patients entered the study, and were included in the analysis of mortality. The death rate in the first 10 years of the disease was not significantly different from that of the general population. Fifty five patients from the study group died (16% up to 10 years of follow up). The most commonly reported causes of death were of cardiovascular and respiratory origin. The other causes of death could be classified into cancer, sepsis, amyloidosis, leukaemia, renal insufficiency of unknown cause, perforation of the oesophagus, probably related to the treatment with non-steroidal anti-inflammatory drugs, and pancytopenia during aurothioglucose treatment. Functional capacity improved significantly during the first six years compared with the value at start. Statistically significant predictors for death were age at the start and male sex.
CONCLUSIONSIn contrast with earlier studies performed, no excess mortality in the first 10 years of an inception cohort of patients with RA was seen. In addition, the functional capacity was relatively constant during the first six years after an initial improvement from baseline. Age at start and male sex were the only statistically significant predictors for death.

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© 2000 by Annals of the Rheumatic Diseases
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