Whitney Palmer

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RA Survival Rates Outpacing that of General Population

Published on the July 13, 2016, Rheumatology Network website

By Whitney L.J. Howell

Advances in drug development and management strategies for rheumatoid arthritis over the past 15 years have improved survival rates for patients, researchers say.

The study appears in the June 23, 2016,Annuals of the Rheumatic Diseases.

To date, there have been no investigations into whether these improvements have positively impacted the lifespan of patients with rheumatoid arthritis. A few studies exist, researchers said, looking into how treatments impacted mortality up to 2004. However, there are none that look at later dates.

In a population-based cohort study, researchers reviewed how standard rheumatoid arthritis treatments impacted patients with this condition and compared the results to similar patients who did not have rheumatoid arthritis. They were also interested in whether other co-morbidities impacted survival.

Led by Yuqing Zhang, M.D., professor of medicine and epidemiology at Boston University School of Medicine, investigators determined rheumatoid arthritis patients treated after the advent of new drugs and management strategies had a longer survival rate than those treated earlier. The study, which looked at patients treated from 1999 to 2014, also revealed co-morbidities did not significantly impact life span.

Throughout the study, researchers surveyed electronic medical records from The Health Improvement Network in the United Kingdom for 10.2 million patients from 580 general practice clinics. They identified all patients, ages 18 to 89, with rheumatoid arthritis and up to five similar individuals who didn’t have the condition. They, then, divided patients into two cohorts: those treated between 1999 and 2006 (10, 126 rheumatoid arthritis patients and 50,546 non-rheumatoid arthritis patients) and those treated between 2007 and 2014 (10, 769 rheumatoid arthritis patients and 53, 749 non-rheumatoid patients).

According to study results, more patients from the early cohort died – and died younger – than patients from the later cohort. Based on the data, 936 rheumatoid arthritis patients from the early cohort, and 2,968 non-rheumatoid arthritis, died. The average ages were 77 and 78.4, respectively. In the later cohort, 605 rheumatoid arthritis patients, and 2,293 non-arthritis patients, died. The average ages were 77.9 and 78.4 respectively.

In terms of relative risk, rheumatoid arthritis patients in the early cohort had a 56 percent higher risk of all-cause mortality, and the later cohort had a 29 percent higher risk, researchers reported.

Investigators also found disease-modifying anti-rheumatic drug use was greater in the later cohort than the earlier one – 81 percent to 65 percent, respectively. And, of those using these medicines, 85 percent of late cohort and 68 percent of early cohort received methotrexate. Dosing and administration modes for these medications also improved between early to later cohorts.

“While patients with rheumatoid arthritis had higher mortality rates than individuals without rheumatoid arthritis in either the early or the late cohorts, the magnitude of difference in mortality was smaller in the late cohorts compared with that in earlier cohorts,” researchers said.

Investigators found age, sex, body mass index, alcohol consumption, and medication use didn’t impact results. However, rheumatoid arthritis patients were more likely to smoke and did have more co-morbidities.

Recent U.K. studies show a tripling (156 percent) of methotrexate use between 2001 and 2012. There was also an increase in the use of tumor necrosis factor inhibitor. Seen together, these measures are seen to reduce rheumatoid arthritis disease activity and to have led to improved longevity for patients.

Not only does this data indicate that early and effective interventions for rheumatoid arthritis help prevent permanent damage, but it also demonstrates that treat-to-target strategies have been utilized more frequently. When taken together, all the findings point to a reduction in rheumatoid arthritis disease activity and improved life longevity.

Further study is needed, however, because not enough data existed to determine actual cause of death in a large number of cases. Researchers also said future studies would be valuable to assess the extent to which improved survival among rheumatoid arthritis patients is directly attributable to the improvement of rheumatoid arthritis management and disease activity.

To read the article at its original location: http://www.rheumatologynetwork.com/rheumatoid-arthritis/ra-survival-rates-outpacing-general-population

July 19, 2016 Posted by | Healthcare | , | Leave a comment

   

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