Temporal trends in mortality in patients with rheumatoid arthritis: a Danish population-based matched cohort study

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Abstract

OBJECTIVES: To investigate the 5-year all-cause mortality in patients with RA compared with the general population.

METHODS: This was a nationwide population-based matched cohort study. RA patients diagnosed between 1996 and the end of 2015 were identified using administrative heath registries and followed until the end of 2020 allowing 5 years of follow-up. Patients with incident RA were matched 1:5 on year of birth and sex with non-RA individuals from the Danish general population. Time-to-event analyses were performed using the pseudo-observation approach.

RESULTS: Compared with matched controls in 1996-2000, the risk difference for RA patients ranged from 3.5% (95% CI 2.7%, 4.4%) in 1996-2000 to -1.6% (95% CI -2.3%, -1.0%) in 2011-15, and the relative risk from 1.3 (95% CI 1.2, 1.4) in 1996-2000 to 0.9 (95% CI 0.8, 0.9) in 2011-15. The age-adjusted 5-year cumulative incidence proportion of death for a 60-year-old RA patient decreased from 8.1% (95% CI 7.3%, 8.9%) when diagnosed in 1996-2000 to 2.9% (95% CI 2.3%, 3.5%) in 2011-15, and for matched controls from 4.6% (95% CI 4.2%, 4.9%) to 2.1% (95% CI 1.9%, 2.4%). Excess mortality persisted in women with RA throughout the study period, while the mortality risk for men with RA in 2011-15 was similar to their matched controls.

CONCLUSIONS: Enhanced improvement in mortality was found in RA patients compared with matched controls, but for sex-specific differences excess mortality was only persistent in women with RA.

Original languageEnglish
Article numberkead325
JournalRheumatology
Volume63
Issue number4
Pages (from-to)1049-1057
Number of pages9
ISSN1462-0324
DOIs
Publication statusPublished - 2 Apr 2024

Bibliographical note

© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Keywords

  • Arthritis, Rheumatoid/epidemiology
  • Cohort Studies
  • Denmark/epidemiology
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Registries
  • prognosis
  • RA
  • pseudo-observation
  • epidemiology
  • mortality
  • outcome

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