Results of a 23-year follow-up study presented at the Annual European Congress of Rheumatology (EULAR 2018) this week suggest early, intensive treatment of rheumatoid arthritis (RA) has long-term benefits including the normalisation of mortality to levels consistent with the general population.
The prospective study looked at the rate of mortality after 23 years follow-up in the COmbinatietherapie Bij Rheumatoide Artritis (COBRA) trial. In the original study, patients with early RA were treated with sulphalasazine (SSZ) monotherapy or a combination of SSZ, low-dose methotrexate and initially high, step-down prednisolone.
Analysis of data from 154 of the 155 original patients showed that 44 patients died (28%); 20 of 75 combination patients and 24 of 79 SSZ patients. The difference in mortality was not significant. In the reference sample of the general population, 55 people died (36%).
The authors said the study of early RA is one of the first to show a normalisation of RA mortality compared to the general population after 23 years of follow up. “This confirms that early, intensive treatment of RA (that can include glucocorticoids) has long-term benefits, and strongly suggests these benefits include normalisation of mortality,” they concluded.