Rheumatoid arthritis (RA) patients have a shorter life-expectancy of six to seven years reports a new
Australian study, though RA is rarely the recorded cause of death.
In the first long term observational study of RA patient life expectancy in an Australian cohort researchers found life years lost for RA male patients was six to eight years and for female RA patients seven to ten years.
After observing over 250 patients for 14 years (1990-2004) the researchers determined the median years lost in RF positive patients was nine years and five and a half years for RF negative patients.
The study found the same number of median years of life lost for erosive and non-erosive RA respectively.
But the news was not all bleak with results suggesting a secular reduction in excess mortality for RA patients.
“This secular difference could be due to a change in the natural history of the disease, in management (drugs or treatment strategies) or in the social environment (access to health services),” the authors from St George Hospital in Sydney said.
Furthermore, as their study cohort was from the pre-biologic DMARD era, changes in patient management since then may translate into further improved life expectancy and a reduction in Standard Mortality Ratios (SMRs). However, this could only be determined by ongoing Australian cohort studies such as the Australian Rheumatology Association Database (ARAD).
Despite a shorter life expectancy for RA patients, only 16 participants had RA listed as the primary cause of death, with circulatory disease and ischaemic heart disease accounting for the largest mortality rates in the cohort.
“We cannot rely only on death certificate reporting of rheumatoid arthritis as this method significantly underestimates deaths attributable to this disease,” the authors said.