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All-cause mortality in systemic rheumatic diseases under treatment compared with the general population, 2015-2019.
Bournia, Vasiliki-Kalliopi; Fragoulis, George E; Mitrou, Panagiota; Mathioudakis, Konstantinos; Tsolakidis, Anastasios; Konstantonis, George; Vourli, Georgia; Paraskevis, Dimitrios; Tektonidou, Maria G; Sfikakis, Petros P.
  • Bournia VK; Joint Rheumatology Program, National and Kapodistrian University of Athens Faculty of Medicine, Athens, Greece.
  • Fragoulis GE; Joint Rheumatology Program, National and Kapodistrian University of Athens Faculty of Medicine, Athens, Greece.
  • Mitrou P; Hellenic Republic Ministry of Health, Athens, Greece.
  • Mathioudakis K; IDIKA SA - e-Government Center for Social Security Services, Athens, Greece.
  • Tsolakidis A; IDIKA SA - e-Government Center for Social Security Services, Athens, Greece.
  • Konstantonis G; Joint Rheumatology Program, National and Kapodistrian University of Athens Faculty of Medicine, Athens, Greece.
  • Vourli G; Department of Hygiene Epidemiology and Medical Statistics, National and Kapodistrian University of Athens Faculty of Medicine, Athens, Greece.
  • Paraskevis D; Department of Hygiene Epidemiology and Medical Statistics, National and Kapodistrian University of Athens Faculty of Medicine, Athens, Greece.
  • Tektonidou MG; Joint Rheumatology Program, National and Kapodistrian University of Athens Faculty of Medicine, Athens, Greece.
  • Sfikakis PP; Joint Rheumatology Program, National and Kapodistrian University of Athens Faculty of Medicine, Athens, Greece psfikakis@med.uoa.gr.
RMD Open ; 7(3)2021 11.
Article in English | MEDLINE | ID: covidwho-1504941
ABSTRACT

OBJECTIVES:

To compare current all-cause mortality rates in rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) versus general population.

METHODS:

In this population-based, retrospective cohort study, anonymised data on 11 186 586 citizens, including all patients with RA (42 735, 79% female), AS (9707, 43% female), PsA (13 779, 55% female), SLE (10 440, 89% female) and SSc (2277, 88% female), (median age of 64/47/54/53/59 years at study entry, respectively), under prescribed treatment between 2015 and 2019, were extracted from the electronic database covering nearly 99% of the Greek population.

RESULTS:

After 15 (patientsgeneral population) matching for gender/age, we found that survival was worse in SSc, followed by SLE and inflammatory arthritis. Compared with the general population HRs for death increased from the first 3 years to 5 years of observation possibly due to increases in disease duration RA (from 0.63 to 1.13 (95% CI 1.05 to 1.22), AS (from 0.62 to 1.01, (95% CI 0.76 to 1.33)), PsA (from 0.68 to 1.06, (95% CI 0.88 to 1.28)), SLE (from 1.52 to 1.98, (95% CI 1.67 to 2.33)) and SSc (from 2.27 to 4.24, (95% CI 3.19 to 5.63)). In both SLE and SSc mortality was increased in men than women and in patients younger than 50 years.

CONCLUSIONS:

Survival rates over 5 years in inflammatory arthritis under treatment are currently becoming comparable (AS/PsA) or slightly higher (RA) than those of the general population. However, all-cause mortality is almost twofold and fourfold higher in SLE and SSc, respectively, being even higher for male and younger patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Arthritis, Rheumatoid / Arthritis, Psoriatic / Rheumatic Diseases / Lupus Erythematosus, Systemic Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Language: English Year: 2021 Document Type: Article Affiliation country: Rmdopen-2021-001694

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Arthritis, Rheumatoid / Arthritis, Psoriatic / Rheumatic Diseases / Lupus Erythematosus, Systemic Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Language: English Year: 2021 Document Type: Article Affiliation country: Rmdopen-2021-001694