You are here

  • Home
  • Archive
  • Volume 72, Issue 11
  • Is early remission associated with improved survival or is arthritis persistency associated with increased mortality in early arthritis? Comparisons with the general population

Article Text

Article menu
Download PDFPDF
Electronic pages
Letter
Is early remission associated with improved survival or is arthritis persistency associated with increased mortality in early arthritis? Comparisons with the general population
  1. Jessica A B van Nies,
  2. Annette H M van der Helm-van Mil
  1. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  1. Correspondence to Jessica A B van Nies, Department of Rheumatology, Leiden University Medical Center, P.O.Box 9600, Leiden 2300 RC, The Netherlands; j.a.b.van_nies{at}lumc.nl

https://doi.org/10.1136/annrheumdis-2013-204182

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    We read the article of Scirè et al with interest,1 evaluating the association between remission and mortality in patients with inflammatory polyarthritis. This study shows that patients achieving remission early in the disease course have an improved survival rate compared with patients never achieving remission. Based on this observation, the authors conclude that achieving remission early in the disease influences the long-term outcome. The question arises which processes underlie their observation. Rheumatoid arthritis (RA) has been associated with an increased mortality risk, which has been attributed to the effects of long-term inflammation.2 We hypothesised that the observation in which patients with remission have an improved survival rate might actually be driven by the association between prolonged inflammation and increased mortality risk.

    We addressed this hypothesis by taking advantage of long-term outcomes of 556 patients with early undifferentiated arthritis or RA that were included in the Leiden Early Arthritis Clinic between 1993 and 1998.3 Treatment in this era was delayed and disease-modifying antirheumatic drugs (DMARDs) were mild. We previously observed that patients included in this era had an increased mortality rate …

    View Full Text

    Footnotes

    • Contributors JABvN analysed the data. JABvN and AHMvdHvM interpreted the data and drafted the manuscript.

    • Funding This work is supported by a Vidi-grant of the Netherlands Organisation for Scientific Research.

    • Competing interests None.

    • Ethics approval Ethics Committee LUMC.

    • Provenance and peer review Not commissioned; externally peer reviewed.