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Women with rheumatoid arthritis have significantly higher risk of mortality

Date:
November 16, 2014
Source:
American College of Rheumatology (ACR)
Summary:
Women with rheumatoid arthritis are at significantly higher risk of all-cause mortality, particularly respiratory causes, compared to women without the disease, according to new research findings. Rheumatoid arthritis is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints. Though joints are the principal body parts affected by RA, inflammation can develop in other organs as well. An estimated 1.3 million Americans have RA, and the disease typically affects women twice as often as men.
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Women with rheumatoid arthritis are at significantly higher risk of all-cause mortality, particularly respiratory causes, compared to women without the disease, according to new research findings presented this week at the American College of Rheumatology Annual Meeting in Boston.

Rheumatoid arthritis is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints. Though joints are the principal body parts affected by RA, inflammation can develop in other organs as well. An estimated 1.3 million Americans have RA, and the disease typically affects women twice as often as men.

Using data from the Nurses' Health Study conducted on 121,700 women gathered from 1976 to 2012, researchers at Brigham and Women's Hospital and Harvard Medical School in Boston validated 964 incident RA cases and identified 28,808 deaths in the entire cohort with 36 years of follow-up. Of the 307 deaths among women with RA, 26 percent were from cancer, 23 percent from cardiovascular disease, and 16 percent from respiratory causes. In contrast, women without RA died from the following causes: 41 percent from cancer, 22 percent from cardiovascular disease, and 7 percent from respiratory causes.

Compared to women without RA, the researchers determined that women with RA had 40 percent increased mortality from all causes, after adjusting for age and other mortality risk factors. This was likely driven by cardiovascular and respiratory causes, but cancer did not appear to be increased. Women with seropositive RA had significantly 51 percent higher risk of death compared to women without RA, whereas the mortality risk in seronegative RA was not statistically different from non-RA women.

"We aimed to study deaths and causes of death in a cohort in which women have been followed very closely before and after development of RA and directly compared to women without RA. All the participants in this study had repeated assessment of behavioral factors, such as cigarette smoking, comorbid diseases such as cardiovascular disease, and other mortality risk factors, enabling us to study the independent effect of having RA on the risk of death," said Dr. Jeffrey Sparks, from Brigham and Women's Hospital in Boston and a lead author of the study.

In the study, the researchers found that each five years of having RA increased the women's mortality by 11 percent compared to women without the disease. Women with seropositive RA had almost three times the respiratory mortality risk compared to women without RA, but women with seronegative RA had no such increased risk. For women with RA, respiratory deaths were due to chronic obstructive pulmonary disease, pneumonia, chronic interstitial lung disease, asthma and other respiratory diseases.

The researchers concluded that women diagnosed with RA have a 1.4 fold increased risk of death from any cause compared to women without RA. Death from respiratory causes appears to be an important but understudied cause of death in RA patients, especially in seropositive RA patients. The study provided evidence of high RA mortality risks that are unexplained by traditional factors such as cigarette smoking.

"This study highlights the clinical necessity of recognizing and addressing complications of RA, such as respiratory disease and cardiovascular disease, which associated with early mortality," Dr. Sparks said.


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Materials provided by American College of Rheumatology (ACR). Note: Content may be edited for style and length.


Cite This Page:

American College of Rheumatology (ACR). "Women with rheumatoid arthritis have significantly higher risk of mortality." ScienceDaily. ScienceDaily, 16 November 2014. <www.sciencedaily.com/releases/2014/11/141116094048.htm>.
American College of Rheumatology (ACR). (2014, November 16). Women with rheumatoid arthritis have significantly higher risk of mortality. ScienceDaily. Retrieved March 18, 2024 from www.sciencedaily.com/releases/2014/11/141116094048.htm
American College of Rheumatology (ACR). "Women with rheumatoid arthritis have significantly higher risk of mortality." ScienceDaily. www.sciencedaily.com/releases/2014/11/141116094048.htm (accessed March 18, 2024).

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