Rheumatoid arthritis-ILD mortality remains stable despite fewer arthritis-related deaths – Healio
Source/Disclosures
Disclosures:
Jeganathan reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Jeganathan reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Rheumatoid arthritis-related mortality rates are declining, but death rates related to rheumatoid arthritis-interstitial lung disease remain stable for adults younger than 65 years, researchers reported.
Niranjan Jeganathan, MD, MS, associate professor of medicine in the division of pulmonary, critical care, hyperbaric, allergy and sleep medicine and the department of medicine at Loma Linda University Health, California, and colleagues conducted a retrospective, population-based study of 36,067,309 deaths in the U.S. to describe RA and RA-ILD mortality rates and trends from 2005 to 2018.
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Utilizing the Multiple Cause of Death Database available through the CDC, 123,012 (0.34%) patients with RA were identified. Of these, 12,180 (9.9%) had RA-ILD. Researchers assessed the age-adjusted mortality rates and trends stratified by patient demographics.
The results, published in the Annals of the American Thoracic Society, found higher RA and RA-ILD mortality rates per 1,000,000 people among adults aged 65 to 74 (80.4 and 10.5), 75 to 84 (230.7 and 23.3) and 85 years and older (434.5 and 25.2). Rates were also higher among women (32.4 and 2.9) than men (16 and 2.1), although ILD prevalence was higher among men with RA compared with women (13.3% vs. 8.7%).
Researchers also observed higher RA mortality rates per 1,000,000 people among Native American and white adults (50.1 and 26.9). Hispanic adults had lower RA mortality rates per 1,000,000 people (20.4 vs. 26.9) but higher RA-ILD mortality rates (3.2 vs. 2.5) compared with white adults.
There was an overall decrease in RA mortality rates per 1,000,000 people from 30.6 in 2005 to 22.2 in 2018. These declines were observed for both men (19.6 vs. 13.8; P < .001) and women (38 vs. 28.3; P < .001) and all race/ethnicity and age groups.
However, RA-ILD mortality rates per 1,000,000 people remained stable among men and women, all races and every age group except for those aged 65 to 74 (11.1 vs. 8.6; P = .04) and 75 to 84 years (24.9 vs. 20.4; P = .004) where there was a decline from 2005 to 2018.
According to the researchers, these findings may suggest that RA therapies and improvement in managing other comorbidities improved overall outcomes for patients with RA but had limited effects among patients with RA-ILD.
“Further studies are warranted to investigate the role of genetics and environmental factors contributing to these differences,” the researchers wrote. “Our findings could facilitate the design of these future studies and also enable appropriate representation in clinical trials of demographic groups that are more significantly affected by this condition.”
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