Ontario study finds 40 to 50 per cent greater mortality rate among rheumatoid arthritis patients than the general population

People with rheumatoid arthritis (RA) have a 40 to 50 per cent higher mortality rate than the general population according to new research conducted at the Institute for Clinical Evaluative Sciences (ICES).

The findings, published in Arthritis Care & Research, show that mortality for RA patients has decreased over time but remains high when compared to the general Ontario population.

“Our study shows that despite substantial improvements in RA management over the past decade, several factors including autoimmune inflammatory burden, genetics and increased comorbidity risk add a substantial disadvantage on survival over time in patients with RA,” says Jessica Widdifield, lead author of the study and post-doctoral fellow at ICES and McGill University.

RA is a chronic inflammatory arthritis affecting one per cent of all adults and two to three per cent of older adults over the age of 65. The autoimmune disorder affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity and disability.

The retrospective population-based study in Ontario from 1996 to 2009 found:

• The number of patients with RA increased from 46,961 to 97,499 over the study period
• The number of deaths among RA patients that is over and above the number of deaths in patients without RA, known as excess mortality rate, is approximately three excess deaths per 1000 people
• This excess mortality in patients with RA remained elevated over time in comparison to patients without RA

“Our findings clearly illustrate the need to understand reasons for inequalities in mortality, particularly surrounding the youngest age groups with the highest relative excess mortality,” adds Widdifield.

An editorial by Dr. Ted Pincus accompanies the paper and indicates that premature mortality is seen in association with many rheumatic diseases.  

The study “Trends in Excess Mortality among Patients with Rheumatoid Arthritis in Ontario, Canada,” was published in Arthritis Care & Research.

Authors: Widdifield J, Bernatsky S, Paterson JM, Tomlinson G, Tu K, Kuriya B, Thorne JC, Pope JE, Hollands S, Bombardier C.   

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

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