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High disability early in RA tied to increased mortality risk, finds study
Canada: Higher self-reported disability and disease activity score (DAS) at 1 year significantly increased all‐cause mortality in patients with early rheumatoid arthritis (ERA), suggests a recent study published in the journal Arthritis & Rheumatology.
Safoora Fatima, University of Western Ontario, London, Ontario, Canada, and colleagues assessed the association of higher self‐reported disability (high HAQ) with hospitalizations and mortality in early rheumatoid arthritis.
It included 1724 patients (mean age 55 years; 72% female) with ERA (symptoms <1 year) who were enrolled in the Canadian Early Arthritis Cohort (CATCH) who initiated DMARDs and had completed HAQ data at baseline and 1 year follow up. Discrete‐time proportional hazards models were used for the estimation of crude and multi‐adjusted associations between HAQ at baseline and 1 year, respectively, with all‐cause mortality in each year of follow up.
Also Read: Early DMARD therapy for rheumatoid arthritis lowers CVD risk: BMJ
Key findings of the study include:
- Over 10 years, 62 deaths (2.4%) were recorded.
- Deceased patients had higher HAQ scores at baseline 1.2 and at 1 year 0.9 vs non‐deceased 1.0 and 0.5.
- DAS28 was higher in deceased vs non‐deceased at baseline [5.4 vs 4.9] and at 1 year [3.6 vs. 2.8].
- Age, male sex, lower education, smoking, more comorbidities, higher baseline disease activity score (DAS) and glucocorticoid use were associated with mortality.
- Contrary to HAQ at baseline, the association between all‐cause mortality and HAQ at 1 year remained significant even after adjusting for confounders.
- HAQ baseline unadjusted hazard OR was 1.46 and adjusted 1.25 vs. HAQ at 1‐year unadjusted hazard OR was 2.58 and adjusted 1.75.
"Higher HAQ and also DAS at 1 year was significantly associated with all‐cause mortality in a large ERA cohort," concluded the authors.
Also Read: Mediterranean diet may protect women smokers from rheumatoid arthritis: Study
The study, "Health Assessment Questionnaire at One Year Predicts All‐Cause Mortality in Patients with Early Rheumatoid Arthritis," is published in the journal Arthritis & Rheumatology.
DOI: https://onlinelibrary.wiley.com/doi/abs/10.1002/art.41513
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751