Does Early RA Treatment Affect Mortality Rates?

Early treatment of rheumatoid arthritis (RA) was associated with lower mortality rates, according to the findings of a recent study presented at the 2018 Annual European Congress of Rheumatology conference in Amsterdam, Netherlands.

“This prospective cohort study of early RA is one of the first to show a normalization of RA mortality compared to the general population after 23 years of follow up,” the researchers stated. “In fact, this trial population had a numerically lower mortality than expected.”
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Using the Dutch state registry, the researchers compared mortality rates among participants in the COBRA trial with a sample from the general population matched by age and gender. The COBRA trial included 155 participants with early RA who were treated with sulphalasazine monotherapy (n=79) or a combination of sulphalasazine, low-dose methotrexate, and initially high, step-down prednisolone (n=76). A total of 154 participants had complete data and were included in the analysis. The mean follow-up was 23 years.

Overall, 44 participants (28%) in the COBRA trial died and 55 people (36%) from the reference sample of the general population died. In the COBRA trial, 20 participants (27%) who received combination therapy died and 24 participants (30%) who received monotherapy died. The differences in mortality among the groups was not significant.

“This confirms that early, intensive treatment of RA (that can include glucocorticoids) has long-term benefits, and strongly suggests these benefits include normalization of mortality,” the researchers concluded.

Reference

Poppelaars PBM, van Tuyl LHD, Boers M. Mortality of the COBRA early rheumatoid arthritis trial cohort after 23 years of follow up. Presented at: Annual European Congress of Rheumatology conference; June 13-16, 2018; Amsterdam, Netherlands. Abstract OP0015.