Many study findings about rheumatoid arthritis (RA) sound negative, but patients with the disease are now getting some encouraging news.
A study published last month on the progress and advancements in RA treatment and management revealed that for the first time in years the mortality rate among people with RA has decreased.
Researchers also noted that people with the disease experience much less disability than in decades past.
The mortality numbers
Data from the World Health Organization (WHO) shows that RA was listed as the underlying cause of death in 8,428 cases in 2011.
That was a decrease from 9,281 deaths in 1987.
The age-standardized mortality rate of RA declined by 3 percent annually from 1987 to 2011.
But people with RA still have a higher mortality rate than the general population.
The Centers for Disease Control and Prevention (CDC) notes that early treatment — within six months of diagnosis — is ideal to help curb aggressive disease activity or early deaths from RA.
What is working?
Researchers are now trying to ascertain which specific approaches have helped bring down the RA mortality rate.
In general, it seems that the long-term outlook for people with RA is improving — but only with early treatment. This was evidenced in a study following a group of people with RA for 20 years.
Early treatment means getting the right diagnosis and “catching” the RA early in the progression of the disease.
There are some mixed opinions within the rheumatology community about what the first line of defense is in RA treatment, but the general consensus is that a more aggressive approach in the earlier stages is best.
People with lower disease activity tended to fare better long term.
But, overall, while people with RA reported a lower disease activity early on, disability rates did tend to rise in people with RA seven years after diagnosis.
The disability reported was moderate but still better than compared with previous decades.
A press release about these discoveries noted that “patients who received treatment within the first six months had a lower risk of death than those who did not receive treatment, after controlling for disease severity.”
“This research emphasizes the importance of early treatment and the long-term benefits of early treatment,” said Suzanne Verstappen, PhD, a senior research fellow at the University of Manchester, and a lead researcher on these study, said in a press statement. “In the early 1990s, when this study started, only 30 percent of patients received early treatment, but this number has increased significantly in the last decade. It's expected that in the next 10 years, newly diagnosed patients will have a better future with respect to functional ability, less severe disease activity, and improved quality of life.”
Issues associated with survival
In the past, there was a higher RA mortality rate due to complications such as lung and heart issues associated with severe RA disease activity.
Other people succumbed to fatal infections from RA medications, or other unique complications associated with RA and its comorbidities.
The higher survival rate is welcome news for people with RA, but there are issues related to living longer with the disease.
“Although increased survival with rheumatoid arthritis is great news, it might lead to a greater share of our aging population having the disease and in need of health services. This needs to be accounted for in healthcare planning,” said study lead author Aliasghar Kiadaliri, PhD, of Lund University in Sweden, in a statement to the press.
People with RA, though, still look at this news as a positive thing.
“With so much bad news regarding the healthcare bill and funding for NIH research being cut and just the difficulties of RA in general, it is nice to get good news for once. I would love to live a longer and healthier life even with having a serious illness like RA,” said Jacqueline Dickson of North Carolina.
“I am only 23 and was just recently diagnosed with rheumatoid arthritis,” added Michelle Herbert of Nevada. “I wondered if it would affect my life expectancy, and told my doctor that I’d try whatever she suggested to make sure my disease didn’t progress too badly. It’s good to know that aggressive treatment early in the disease is seen as a positive, but I just hope my doctors caught it in time because I had so many years of pain.”
Perhaps Brad Smith of New York, a young man with RA, is the one to sum it up best.
“I’ll take any good news when it comes to RA,” he said.