Causes of death in rheumatoid arthritis patients

Mortality rates were increased for patients with rheumatoid arthritis relative to the general population across all causes of death in a recent Arthritis Care & Research analysis.

The study included 87,114 rheumatoid arthritis patients in Ontario and 348,456 age/sex/area-matched general population comparators from 2000 to 2013. During follow-up, 14% of rheumatoid arthritis patients and 9% of individuals in the general population died.

While the causes of death were similar in the two groups—most frequently being circulatory system diseases, cancer, and respiratory conditions (including respiratory infections), patients with rheumatoid arthritis were dying at a younger age. The potential life years lost before the age of 75 years among rheumatoid arthritis patients was approximately double that among those in the general population.

"Our findings offer new insights into the importance of cardiovascular and respiratory contributions—including pneumonia—to shortening patient lives," said lead author Dr. Jessica Widdifield, of Sunnybrook Research Institute, in Toronto, adjunct scientist at the Institute for Clinical Evaluative Sciences (ICES) and Assistant Professor at the Institute of Health Policy, Management & Evaluation, University of Toronto. She noted that deaths in patients with rheumatoid arthritis are largely attributed to complications of the disease and its treatment as well as to other comorbid conditions.

"One in three deaths was attributed to heart disease. This finding underscores the importance of increased efforts to prevent heart disease and its progression, and patients and physicians should be thinking about this early in the disease course, and earlier in the patient's life. The heightened risk associated with respiratory diseases and respiratory infections should also be emphasized."