Early intervention and mortality risk – are there benefits for patients with rheumatoid arthritis?
Rheumatoid arthritis (RA) is a long-term condition. It causes painful inflammation in the joints. To treat RA, patients take medication to reduce inflammation. They are called anti-rheumatic disease-modifying drugs or DMARDs. The aim of RA treatment is to achieve low disease activity (LDA) or remission (no symptoms). This approach is called ‘treatment to target’ (TTT).
Mortality (death) risk is thought to be higher in patients with RA than the general population. Early intervention in RA may improve this risk. It is unclear if TTT improves mortality risk in RA.
Methods & findings
This study included 155 patients with early RA. These patients were enrolled in a main study that compared DMARD treatment. There was a 23-year follow-up in this study. The authors analyzed mortality rates in the main study. These rates were compared to the general population (GP) of the Netherlands. Data on medication, disease activity, and functional disability were also analyzed. Mortality rates were similar in RA patients and GP. Certain factors were associated with greater mortality risk. These included high functional disability score and shorter disease duration. The level of joint damage after 28 weeks was also linked to higher mortality risk. Certain cell surface markers were also linked to mortality. These included the human leukocyte antigen (HLA)-DR.
The bottom line
The authors concluded that mortality rates were similar to the general population in patients with RA treated early in the disease.
The fine print
The number of patients in this study was relatively small. Larger studies are needed to confirm the results. Also, the cause of death was not available for analysis.
If you have any concerns regarding RA treatment, please consult with your physician.