Men with Rheumatoid Arthritis at Increased Risk of Death

Rheumatoid arthritis (RA) is a form of arthritis that causes pain, swelling, stiffness and loss of function in the joints, most commonly the wrist and fingers.  While most studies regarding mortality in rheumatoid arthritis have focused on women, who more predominantly are diagnosed with the disease, some data suggests that mortality may be greater in men. Ted R. Mikuls, from the the Veterans Affairs Medical Center (Nebraska, USA), and colleagues analyzed data collected from 1,015 men, average age at enrollment of 65 years,  enrolled in the VA rheumatoid arthritis (VARA) registry, with an average disease duration of 12 years, during a seven-year period.  Rheumatoid factor was positive in 81%, of subjects, with anti-cyclic citrullinated protein antibody positive in 76%. Over 20% of the subjects had confounding medical conditions including diabetes, COPD, and cardiovascular disease, and more than 80% were current or past smokers. During 2,314 patient-years of follow-up, there were 138 deaths, resulting in a crude mortality rate of 5.9 deaths per 100 patient-years, compared with a standardized mortality ratio of 2.1 among men in the general US population. .  Observing that: “Mortality rates among US male veterans with RA are more than twice those of age-matched men in the general population,” the researchers urge that: “ These results suggest that optimizing disease control … could improve long-term survival in this population.”