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Long-Term Follow-up Shows Increased Mortality Risk for Women With RA
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Women with rheumatoid arthritis carried a significantly higher mortality risk compared with women who did not have the condition, according to results from 36 years of prospective follow-up in the Nurses’ Health Study.
“Clinicians should be aware of the increased mortality risk among [rheumatoid arthritis] RA patients, particularly respiratory disease–related mortality in seropositive RA,” Jeffrey A. Sparks, MD, MMSc, from the Department of Medicine at the Division of Rheumatology, Immunology, and Allergy at Brigham and Women’s Hospital in Boston, and colleagues wrote in their study. “Further research is warranted to determine factors that may reduce the excess mortality in RA, particularly from cardiovascular and respiratory causes.”
Jeffrey A. Sparks
Sparks and colleagues evaluated 119,209 women in the Nurses’ Health Study who, at enrollment in 1976, did not show signs of connective tissue disease, according to the abstract. The researchers issued biennial questionnaires to women that collected comorbidity and lifestyle data. The investigators also reviewed medical records and death certificates for cases of incident RA and mortality, respectively.
They found 964 incident RA cases and 28,808 deaths during the follow-up period. Sparks and colleagues identified 307 deaths attributed to RA. Of these cases, the cause of mortality was cancer in 80 patients (26%); cardiovascular disease in 70 patients (23%); and respiratory disease in 44 patients (14%), according to the abstract. Compared to women without RA, women with RA had increased mortality independent of other risk factors for mortality (hazard ratio = 1.40) and cardiovascular disease mortality (hazard ratio = 1.45). However, Sparks and colleagues noted these patients did not have an increased risk of mortality from cancer (hazard ratio = 0.93).
Regarding respiratory disease and mortality, women with RA showed significantly increased respiratory disease mortality (hazard ratio= 2.06). Specifically, women with seropositive RA had a nearly three-fold rate of mortality compared with women without RA (hazard ratio = 2.67), according to the abstract. – by Jeff Craven
Disclosures: The researchers received grants from NIH, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the Harvard Catalyst | Harvard Clinical and Translational Science Center, the National Center for Advancing Translational Sciences and by Harvard University and its affiliated academic health care centers. Sparks was supported by a Rheumatology Research Foundation Scientist Development Award and by the NIH Loan Repayment Award.
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