Early RA treatment important for long-term outcomes

(HealthDay)—Early treatment of rheumatoid arthritis (RA) is important for long-term outcomes, and there has been a decrease in mortality rates attributable to RA, according to two studies published online April 20 in Arthritis & Rheumatology.

James M. Gwinnutt, from the University of Manchester in the United Kingdom, and colleagues described outcomes over 20 years from symptom onset for 602 patients with RA. The researchers found that median disease activity was low during follow-up. After year one, median Health Assessment Questionnaire-Disability Index (HAQ) increased but remained at low/moderate levels. The early treatment (ET: ≤six months after symptom onset) and late treatment (LT: treatment >six months) groups had reduced mortality risk compared with never treatment (NT). Over follow-up, the ET group had comparable HAQ to NT; the LT group had increased disability.

Aliasghar A. Kiadaliri, Ph.D., from Lund University in Sweden, and colleagues examined trends in RA as an underlying cause of death (UCD) in 31 countries during 1987 to 2011. They calculated age-standardized mortality rates (ASMR) using data from the World Health Organization mortality database and the United Nations. The researchers found that from 1987 to 2011 there was a decrease in the absolute number of deaths with RA registered as UCD, from 0.12 to 0.09 percent of all-cause deaths. There was a 48.2 percent reduction in the mean ASMR, from 7.1 to 3.7/million person-years in 1987-1989 to 2009-2011.

"Mortality rates attributable to RA have declined globally," Kiadaliri and colleagues write. "However, there were substantial between-country disparities in RA mortality."

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