scholarly journals Improved survival in rheumatoid arthritis: a general population-based cohort study

2016 ◽  
Vol 76 (2) ◽  
pp. 408-413 ◽  
Author(s):  
Yuqing Zhang ◽  
Na Lu ◽  
Christine Peloquin ◽  
Maureen Dubreuil ◽  
Tuhina Neogi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Mortality Rate ◽  
General Population ◽  
Hazard Model ◽  
Population Based ◽  
New Drugs ◽  
Health Improvement ◽  
The Past ◽  
Comparison Cohort

ObjectiveMortality trends of rheumatoid arthritis (RA) are largely unknown over the past decade when new drugs and management strategies have been adopted to effectively treat RA.MethodsUsing The Health Improvement Network, an electronic medical record database representative of the UK general population, we identified patients with incident RA and up to five individuals without RA matched for age, sex and year of diagnosis between 1999 and 2014. The RA cohort was divided in two sub-cohorts based on the year of RA diagnosis: the early cohort (1999–2006) and the late cohort (2007–2014). We compared mortality rates, HRs (using a Cox proportional hazard model) and rate differences (using an additive hazard model) between RA and non-RA cohorts adjusting for potential confounders.ResultsPatients with RA diagnosed between 1999 and 2006 had a considerably higher mortality rate than their comparison cohort (ie, 29.1 vs 18.0 deaths/1000 person-years), as compared with a moderate difference in patients with RA diagnosed between 2007 and 2014 and their comparison cohort (17.0 vs 12.9 deaths/1000 years). The corresponding absolute mortality rate differences were 9.5 deaths/1000 person-years (95% CIs 7.5 to 11.6) and 3.1 deaths/1000 person-years (95% CI 1.5 to 4.6) and the mortality HRs were 1.56 (95% CI 1.44 to 1.69) and 1.29 (95% CI 1.17 to 1.42), respectively (both p values for interaction <0.01).ConclusionThis general population-based cohort study indicates that the survival of patients with RA has improved over the past decade to a greater degree than in the general population. Improved management of RA and its associated comorbidities over recent years may be providing a survival benefit.

scholarly journals Explanatory Style in Patients with Rheumatoid Arthritis: An Unrecognized Predictor of Mortality

2016 ◽  
Vol 44 (2) ◽  
pp. 170-173 ◽  
Author(s):  
Aaron D. Crowson ◽  
Robert C. Colligan ◽  
Eric L. Matteson ◽  
John M. Davis ◽  
Cynthia S. Crowson
Keyword(s):  
Rheumatoid Arthritis ◽  
Mortality Rate ◽  
Minnesota Multiphasic Personality Inventory ◽  
Explanatory Style ◽  
Population Based ◽  
Similar Magnitude ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Comparison Cohort ◽  
Pessimistic Explanatory Style

Objective.To determine whether pessimistic explanatory style altered the risk for and mortality of patients with rheumatoid arthritis (RA).Methods.The study included subjects from a population-based cohort with incident RA and a non-RA comparison cohort who completed the Minnesota Multiphasic Personality Inventory.Results.Among 148 RA and 135 non-RA subjects, pessimism was associated with development of rheumatoid factor (RF)–positive RA. Pessimism was associated with an increased risk of mortality [HR 2.88 with similar magnitude to RF+ (HR 2.28)].Conclusion.Pessimistic explanatory style was associated with an increased risk of developing RA and increased mortality rate in patients with RA.

scholarly journals Increased risk of COVID ‐19 in patients with rheumatoid arthritis: a general population‐based cohort study

2021 ◽  
Author(s):  
Yilun Wang ◽  
Kristin M D’Silva ◽  
April M Jorge ◽  
Xiaoxiao Li ◽  
Houchen Lyv ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
General Population ◽  
Population Based ◽  
Increased Risk

scholarly journals The Association of Periodontal Treatment and Decreased Pneumonia: A Nationwide Population-Based Cohort Study

2020 ◽  
Vol 17 (1) ◽  
pp. 356 ◽  
Author(s):  
Li-Chiu Yang ◽  
Yih-Jane Suen ◽  
Yu-Hsun Wang ◽  
Tai-Chen Lin ◽  
Hui-Chieh Yu ◽  
...  
Keyword(s):  
Cohort Study ◽  
General Population ◽  
Periodontal Diseases ◽  
Population Based ◽  
Periodontal Treatment ◽  
Rank Test ◽  
Research Database ◽  
Comparison Cohort ◽  
Comparison Groups

Pneumonia is a common respiratory infectious disease that involves the inflammation of the pulmonary parenchyma. Periodontal disease is widespread and correlated with pneumonia. However, the relationship between periodontal treatment and clinical infectious outcomes in patients with pneumonia has remained undetermined. The aim of this study was to investigate the association between periodontal treatment and the risk of pneumonia events in the Taiwanese population. A nationwide population-based cohort study was conducted using data from the Taiwanese National Health Insurance Research Database (NHIRD). A total of 49,400 chronic periodontitis patients who received periodontal treatment from 2001 to 2012 were selected. In addition, 49,400 healthy individuals without periodontal diseases were picked randomly from the general population after propensity score matching according to age, gender, monthly income, urbanization, and comorbidities. The Cox proportional hazard regression analysis was adopted to assess the hazard ratio (HR) of pneumonia between the periodontal treatment cohort and the comparison cohort. The average ages of the periodontal treatment and comparison groups were 44.25 ± 14.82 years and 44.15 ± 14.5 years, respectively. The follow up durations were 7.66 and 7.41 years for the periodontal treatment and comparison groups, respectively. We found 2504 and 1922 patients with newly diagnosed pneumonia in the comparison cohort and the periodontal treatment cohort, respectively. The Kaplan–Meier plot revealed that the cumulative incidence of pneumonia was significantly lower over the 12 year follow-up period in the periodontal treatment group (using the log-rank test, p < 0.001). In conclusion, this nationwide population-based study indicated that the patients with periodontal treatment exhibited a significantly lower risk of pneumonia than the general population.

scholarly journals Statin use and mortality in rheumatoid arthritis: a general population-based cohort study

2015 ◽  
Vol 75 (7) ◽  
pp. 1315-1320 ◽  
Author(s):  
Sara R Schoenfeld ◽  
Leo Lu ◽  
Sharan K Rai ◽  
John D Seeger ◽  
Yuqing Zhang ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
General Population ◽  
Population Based ◽  
Statin Use

scholarly journals Risk of venous thromboembolism in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a general population-based cohort study

2017 ◽  
Vol 39 (39) ◽  
pp. 3608-3614 ◽  
Author(s):  
Alexis Ogdie ◽  
Neilia Kay McGill ◽  
Daniel B Shin ◽  
Junko Takeshita ◽  
Thorvardur Jon Love ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Psoriatic Arthritis ◽  
Venous Thromboembolism ◽  
General Population ◽  
Population Based

THU0086 The Survival Impact of Statins in Rheumatoid Arthritis: A General Population-Based Cohort Study

2015 ◽  
Vol 74 (Suppl 2) ◽  
pp. 223.2-224 ◽  
Author(s):  
S.R. Schoenfeld ◽  
L. Lu ◽  
S. Rai ◽  
Y. Zhang ◽  
H.K. Choi
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
General Population ◽  
Population Based

scholarly journals The risk of cardiovascular disease in systemic sclerosis: a population-based cohort study

2012 ◽  
Vol 72 (7) ◽  
pp. 1188-1193 ◽  
Author(s):  
Ada Man ◽  
Yanyan Zhu ◽  
Yuqing Zhang ◽  
Maureen Dubreuil ◽  
Young Hee Rho ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Cardiovascular Risk ◽  
Systemic Sclerosis ◽  
General Population ◽  
Cardiovascular Risk Factors ◽  
Population Based ◽  
Incidence Rates ◽  
Increased Risk ◽  
Comparison Cohort

ObjectivesTo evaluate the risk of incident myocardial infarction (MI), stroke and peripheral vascular disease (PVD) in individuals with systemic sclerosis (SSc) in a general population context.MethodsWe conducted a cohort study using a UK primary care database containing records from 1986 to 2011. SSc diagnoses, outcomes and cardiovascular risk factors were identified from electronic medical records. We conducted two cohort analyses: (1) MI and stroke, and (2) PVD, excluding individuals with prevalent disease at baseline for each analysis. We estimated HRs comparing SSc with age-, sex- and entry time-matched comparison cohorts, adjusting for potential cardiovascular risk factors.ResultsAmong 865 individuals with SSc (85.8% women, mean age 58.7 years), the incidence rates (IRs) of MI and stroke were 4.4 and 4.8 per 1000 person-years (PY), versus 2.5 and 2.5 per 1000 PY in the comparison cohort. The corresponding adjusted HRs were 1.80 (95% CI 1.07 to 3.05) for MI and 2.61 (95% CI 1.54 to 4.44) for stroke. Among 858 individuals with SSc (85.3% female, mean age 58.9 years), the IR of PVD was 7.6 per 1000 PY versus 1.9 per 1000 PY in the comparison cohort, with an adjusted HR of 4.35 (95% CI 2.74 to 6.93).ConclusionsThese findings provide the first general population-based evidence that SSc is associated with an increased risk of developing MI, stroke and PVD. Further insight into disease mechanisms, as well as how disease subtype, organ involvement and medication use may alter these increased risks, is needed.

The risk of pulmonary embolism and deep vein thrombosis in rheumatoid arthritis: a UK population-based outpatient cohort study

2012 ◽  
Vol 72 (7) ◽  
pp. 1182-1187 ◽  
Author(s):  
Hyon K Choi ◽  
Young-Hee Rho ◽  
Yanyan Zhu ◽  
Lucia Cea-Soriano ◽  
Juan Antonio Aviña-Zubieta ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Pulmonary Embolism ◽  
Cohort Study ◽  
Deep Vein Thrombosis ◽  
General Population ◽  
Population Based ◽  
Incidence Rates ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Deep Vein

BackgroundRecent hospital-based studies have suggested a sixfold increased risk of pulmonary embolism (PE) in rheumatoid arthritis (RA) in the year following admission. We evaluated the risk of PE and deep vein thrombosis (DVT) and associated time trend among RA patients (84.5% without a history of hospitalisation during the past year) derived from the general population.MethodsWe conducted a cohort study using an electronic medical records database representative of the UK general population, collected from 1986 to 2010. Primary definitions of the RA cohort (exposure) and PE/DVT outcomes required physician diagnoses followed by corresponding treatments. We estimated relative risks (RRs) of PE and DVT compared with a matched non-RA comparison cohort, adjusting for age, sex, smoking, body mass index, comorbidities and hospitalisations.ResultsAmong 9589 individuals with RA (69% female, mean age of 58 years), 82 developed PE and 110 developed DVT (incidence rates, 1.5 and 2.1 per 1000 person-years). Compared with non-RA individuals (N=95 776), the age-, sex- and entry-time-matched RRs were 2.23 (95% CI 1.75 to 2.86) for PE and 2.20 (CI 1.78 to 2.71) for DVT. Adjusting for other covariates, the corresponding RRs were 2.16 (CI 1.68 to 2.79) and 2.16 (CI 1.74 to 2.69). The time-specific RRs for PE were 3.27, 1.88 and 2.35 for follow-up times of <1 year, 1–4.9 years, and ≥5 years, and corresponding RRs for DVT were 3.16, 1.82 and 2.32.ConclusionsThis population-based study indicates an increased risk of PE and DVT in RA, supporting increased monitoring of venous-thromboembolic complications and risk factors in RA, regardless of hospitalisation.

scholarly journals Mortality in Patients with Rheumatoid Arthritis: A Retrospective Cohort Study and Systematic Review

2021 ◽  
Vol 6 (1) ◽  
pp. 5
Author(s):  
Greta Charukevič ◽  
Dalia Miltinienė ◽  
Jolanta Dadonienė
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Cohort Study ◽  
General Population ◽  
Mortality Risk ◽  
Retrospective Cohort ◽  
Meta Analysis ◽  
Population Based ◽  
All Cause Mortality ◽  
Standardized Mortality Ratios

Background and Objectives: Mortality rates among patients with rheumatoid arthritis (RA) have been reported to be higher than in the general population. The long-term prognosis of RA has improved in recent years due to early diagnosis, as well as effective pharmacological treatment, and this may be able to diminish the excess mortality risk. This study was designed to investigate mortality (a) in patients with RA in a retrospectively defined national RA cohort in comparison with the general Lithuanian population, and (b) to conduct a systematic review of the literature from different countries and meta-analysis. Materials and Methods: In this national retrospective cohort study, patients with a first-time diagnosis of RA in the period between 1 January 2013 and 31 December 2017 were identified from the Lithuanian Compulsory Health Insurance Information System database SVEIDRA. All cases were cross-checked with the Health Information Center at the Institute of Hygiene, for the vital status of these patients and date of death if documented. The standardized mortality ratios (SMRs) with 95% confidence intervals (CI) obtained for all-cause mortality in patients with RA adjusted for age, sex, and calendar year were calculated. The search for published studies using the combination of keywords “rheumatoid arthritis AND standardized mortality ratio” was performed in MEDLINE (via PubMed, OVID, and EBSCO), Science Direct, Taylor & Francis, and Springer databases. Studies were selected according to described inclusion and exclusion criteria listed in the paper, and a meta-analysis was conducted. A random-effect meta-analysis model was used to compute the pooled standardized mortality ratios (meta-SMRs). Results: Overall, 4623 patients with newly diagnosed RA during the 2013–2017 period were identified and enrolled in the Lithuanian population-based cohort. The mean age of patients at the time of RA diagnosis was 58.7 (standard deviation (SD) 15.1) years, and 77.1% of the patients were women. The estimated SMR for all-cause mortality was 1.15 (95% CI 1.02, 1.29). The SMR for men (SMR 1.14, 95% CI 0.94, 1.39) was higher than for women (SMR 1.03, 95% CI 0.89, 1.19). A systematic literature search revealed 12 studies meeting the inclusion criteria, starting from 2010 to 2020, representing 50,072 patients. The meta-SMR in patients with RA for all-cause mortality was 1.41 (95% CI 1.29, 1.55). All-cause mortality risk was higher for men (meta-SMR 1.53, 95% CI 1.31, 1.78) than for women (meta-SMR 1.46, 95% CI 1.2, 1.77). Conclusions: In a retrospectively defined population-based national RA cohort, a 15% excess risk of death was observed among patients with RA compared to the general Lithuanian population. Patients with RA have a higher mortality risk than the general population. Published data indicate that the risk of mortality is increased by 41% in patients with RA compared to the general population. Excessive all-cause mortality risk is higher in men than in women. National data showed lower standardized mortality compared to literature data.

scholarly journals 1315Influence of comorbidity on mortality in patients with Rheumatoid Arthritis 1980-2015: A longitudinal population-based study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Khalid Almutairi ◽  
Johannes Nossent ◽  
David Preen ◽  
Helen Keen ◽  
Charles Inderjeeth
Keyword(s):  
Rheumatoid Arthritis ◽  
Mortality Rate ◽  
General Population ◽  
Western Australia ◽  
Population Level ◽  
Mortality Rates ◽  
Population Based ◽  
Icd 10 ◽  
Hospital Morbidity ◽  
Rate Ratios

Abstract Background To describe temporal changes in mortality rates for patients with Rheumatoid arthritis (RA) in relation to comorbidity accrual from 1980-2015 in Western Australia (WA). Methods Using population-level linked data from WA health administrative datasets (hospital morbidity, emergency department and death data) we followed 17,125 RA patients (ICD-10-AM M05.00–M06.99, ICD-9-CM 714) from 1980- 2015. Comorbidity was ascertained using the Charlson Comorbidity Index (CCI). Mortality rate ratios (MRR) were calculated per decade between the RA cohort and the WA general population by direct age standardisation method, Results During 356,069 patient-years, a total of 8955 (52%) deaths occurred in the RA cohort. The highest prevalence of comorbidity (688.6 per 1000 separations) was in the period 1991-2000 following a 1.3% average annual increase since 1980. In-hospital mortality rate was highest (26.7 deaths per 1000 separations) in the same period. After 2001, both RA comorbidity and mortality rates decreased annually by -0.5% and -4.8%, respectively, with annual changes of -4.4% to -2% and from 2011-2015, respectively. The overall mortality rate in RA patients after age adjustment was 2.5-times (95%CI: 2.52-2.65) higher than the general population between 1980-2015 and 1.5-times (95%CI: 1.39-1.81) for 2011-2015. Conclusions The annual comorbidity prevalence and mortality rates in WA have decreased significantly since 2001 reflecting improvements in the management of RA and comorbidity. Key messages The mortality rate in Rheumatoid Arthritis patients in Western Australia remains 1.5-times higher than their community.

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