Rheumatoid arthritis-ILD associated with excess mortality
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Rheumatoid arthritis-related interstitial lung disease was associated with significantly higher rates of excess mortality compared with the general population, according to new research published in BMC Pulmonary Medicine.
“Rheumatoid arthritis-ILD is associated with decreased survival. In this real-world, longitudinal study, mortality among patients with rheumatoid arthritis-ILD was significantly higher than in [the] general population of Madrid,” Maria A. Nieto, MD, from the department of pneumology at the Clinical Hospital San Carlos and the Complutense University of Madrid, Spain, and colleagues wrote.
The researchers conducted the real-world, longitudinal, multicentric, observational study of 47 patients with rheumatoid arthritis-ILD (RA-ILD; mean age, 72 years; 70.2% women) in Madrid from 2005 to 2015 who were followed until October 2018. Patients were included only if they had a diagnosis of ILD.
The primary outcome was all-cause mortality.
During a mean follow-up of 5.3 years, 16 patients (34%) died. The most frequent causes of death were progression of ILD, acute exacerbation of ILD or pneumonia (62.5% of deaths). Other causes of death included abdominal sepsis (12.5% of deaths), neoplasia (6.25% of deaths), cardiological disease (6.25% of deaths), cognitive deterioration (6.25% of deaths) and one death with no specific cause.
The mortality rate was 64.3 per 1,000 patient years. The overall standardized mortality risk was 2.57.
The rate of mortality was 10% mortality at 3 years, 30% at 6 years and 50% at 8.3 years after ILD diagnosis.
In addition, usual interstitial pneumonia radiographic ILD pattern was associated with higher risk for mortality compared with nonspecific interstitial pneumonia after adjusting for confounders.
“Our results support that usual interstitial pneumonia pattern increases the risk of mortality regardless of other factors,” the researchers wrote.
Researchers also observed the highest standardized mortality risk in women aged 65 to 74 years compared with men the same age (6.8 vs. 0) or women aged 55 to 64 years (6.8 vs. 0), 75 to 84 years (6.8 vs. 2.3) or 85 years or more (6.8 vs. 1.2).