What Is the RA Mortality Gap?

The mortality rate for people with Rheumatoid Arthritis is higher than average and not improving with that of the general population. (1)

Chief factors in RA mortality include Rheumatoid heart disease, pulmonary involvement, persistent inflammation, infections due to immune-suppressing medications, spinal cord compression, and lack of preventive care in RA patients.

It is quite difficult to assess RA mortality rates since “Rheumatoid Arthritis” is seldom recorded as cause of death, even when it is the cause. This is partially due to lack of familiarity by physicians of the ways that RA affects vital organs and failure to mention RA on death certificates.
(2)
A thorough overview of mortality and Rheumatoid Arthritis examined RA mortality trends over the last 60 years. Most significantly, mortality rates in RA patients are 1.5 – 1.6 fold higher than the general population, but only 25% of RA patients had their RA status reported on the death certificate.

Interpretation of relative mortality rates is also difficult, especially since men or older people are more likely to die, independently of RA.

Studies showing possible lower mortality with DMARD treatment are short term. More studies of RA mortality are needed, especially long-term studies.

Several tables and graphs illustrate the study, such as this graph (in screenshot below) showing possible predictors of RA mortality. As you can see, hand x-rays are not as significantly related to mortality as physical function (functional status) and comorbidities are. The study noted that functional status is not recorded in most RA reports.

More on mortality and Rheumatoid Arthritis

Oxford Rheumatology Journal: What Kills Patients with Rheumatoid Arthritis?

Articles about mortality and RA on RAWarrior.com.

Footnote

1)  Colwell, Carolyn. “Rheumatoid Arthritis Death Rate Unchanged.” ABC News. March, 2011.

2)  “Death certificate and mortality in rheumatoid arthritis.”  PubMed.