Early, intensive treatment of RA offers long-term benefits, may normalise mortality rates

June 15, 2018, European League Against Rheumatism

The results of a 23-year, follow-up study presented today at the Annual European Congress of Rheumatology (EULAR 2018) suggest early, intensive treatment of rheumatoid arthritis has long-term benefits including the normalisation of mortality to levels consistent with the general population.

"We know that the adverse effects of rheumatoid arthritis on the body only become truly apparent after more than a decade," said Professor Robert Landewé, Chairperson of the Scientific Programme Committee, EULAR. "Therefore, it is really interesting to see these data supporting early therapy after such a long period of follow-up."

Rheumatoid arthritis (RA) is a that affects a person's joints, causing pain and disability. It can also affect internal organs. Rheumatoid arthritis is more common in older people, but there is also a high prevalence in young adults, adolescents and even children, and it affects women more frequently than men.

Mortality in patients with RA is higher than in the general population. There have been many advances in management which have demonstrated improved morbidity rates, however evidence of improved rates has remained elusive.

"Our results confirm that early, intensive treatment of , including use of glucocorticoids, has long-term benefits", said Professor Maarten Boers, VU University Medical Center, Amsterdam, The Netherlands (study author). "Importantly, this study is one of the first to show a normalisation of RA mortality compared to the general population after 23 years of follow-up."

This prospective study looked at the rate of mortality after 23 years follow-up of the COBRA (COmbinatietherapie Bij Rheumatoide Artritis) trial. In the original study, patients with early RA were treated with sulphalasazine (SSZ) monotherapy or a combination of SSZ, low-dose methotrexate and initially high, step-down prednisolone. Results demonstrated the combined therapy regimen offered additional disease control over SSZ alone. In 2010, after 11 years of follow up, another study showed numerically (but not significantly) lower mortality in patients on the combined therapy regimen compared to patients with SSZ monotherapy.

The current study included data from 154 of the 155 original with a mean follow-up time of 23 years (in those that did not die). Using a reference sample matched for age and gender, investigators demonstrated numerically (but not significantly) of the study participants (44/154, 28%) compared to the (55/154, 35%). Within the study , 20/75 (27%) died who were randomised to the combined therapy regimen, and 24/79 (30%) on SSZ alone. The difference between the two therapeutic approaches was not significant and the positive trend for combined therapy over SSZ decreased over time.

Explore further: Rates of depression and anxiety may correlate with disease activity in early RA

More information: Abstract number: OP0015 , DOI: 10.1136/annrheumdis-2018-eular.3675

Related Stories

Rates of depression and anxiety may correlate with disease activity in early RA

June 15, 2018
The results of a study to be presented at the Annual European Congress of Rheumatology (EULAR 2018) suggest that rates of anxiety and depression in patients with rheumatoid arthritis correlate with measures of disease activity ...

Study suggests siblings of people with RA are at increased risk of acute coronary syndrome

June 15, 2018
The results of a study presented today at the Annual European Congress of Rheumatology (EULAR 2018) demonstrate an increased risk of acute coronary syndrome (ACS) in siblings of individuals with rheumatoid arthritis (RA), ...

Gum disease may be a key initiator of rheumatoid arthritis related autoimmunity

June 15, 2018
The results of a study presented at the Annual European Congress of Rheumatology (EULAR 2018) demonstrates increased levels of gum disease, and disease-causing bacteria, in individuals at risk of rheumatoid arthritis (RA).

Frequency of joint replacements halved in rheumatoid arthritis patients between 1997-2010

June 13, 2018
The results of two studies presented today at the Annual European Congress of Rheumatology (EULAR 2018) investigate joint replacement procedures in rheumatoid arthritis (RA) patients. The first study demonstrates that joint ...

Rheumatoid arthritis in pregnancy associated with low birth weight and premature birth

June 14, 2018
The results of a study presented today at the Annual European Congress of Rheumatology (EULAR 2018) demonstrate that pregnancies in women with rheumatoid arthritis are associated with premature delivery and low birth weight.

Causes of death in rheumatoid arthritis patients

March 7, 2018
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.

Recommended for you

Dietary carbohydrates could lead to osteoarthritis, new study finds

August 9, 2018
Do your knees ache? According to new findings from the Oklahoma Medical Research Foundation, your diet could be a culprit.

Joint study raises questions about treatments for arthritis

August 3, 2018
A study examining how molecules are transported into knee-joint tissue could have major implications for understanding and treating arthritis.

Researchers identify new arthritis severity gene

July 26, 2018
A new gene associated with disease severity in models of rheumatoid arthritis has been identified by researchers at the Icahn School of Medicine at Mount Sinai. The discovery could provide a new pathway for treatment and ...

How the brain plays a role in rheumatoid arthritis inflammation

June 18, 2018
In patients with chronic inflammatory conditions, such as rheumatoid arthritis, there has been limited understanding of how this inflammation affects the brain.

New 3-D imaging analysis technique could lead to improved arthritis treatment

June 18, 2018
An algorithm to monitor the joints of patients with arthritis, which could change the way that the severity of the condition is assessed, has been developed by a team of engineers, physicians and radiologists led by the University ...

Joint resolution: A link between Huntington's disease and rheumatoid arthritis

May 15, 2018
Using new analytic tools, researchers at University of California San Diego School of Medicine and the Icahn School of Medicine at Mount Sinai have decoded the epigenetic landscape for rheumatoid arthritis (RA), a common ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.