Berlin, Germany, June 7 2012: According to a study presented today at EULAR 2012, the Annual Congress of the European League Against Rheumatism, patients with rheumatoid arthritis (RA) who are prescribed biologic treatments have a significantly lower mortality risk (adjusted hazard ratio [HR]: 0.61) than those just treated with traditional disease modifying anti-rheumatic drugs (DMARDs).The study also found the mortality was similar irrespective of the method of action of biologics (anti-tumour necrosis factor drugs [anti-TNFs] or rituximab).
Results of the German study of 8,908 patients demonstrated that the mortality rate decreased from 20.6 in those treated with non-biologic DMARDS to 10.6 in those exposed to anti-tumour necrosis factor (anti-TNFs) drugs, and likewise to 12.7 for those treated with rituximab.
Further analyses showed that men and women with RA had a shortened life expectancy of 2.2 years compared to the general population. Patients with a mean DAS28* below 4.1 had normal life expectancies whereas of patients with a mean DAS28 score of >4.1 women died 5.6 years earlier than age and sex matched subjects from the general population, whilst males died 4.8 years earlier.
"It is well-known that patients with RA have lower life expectancies than the general population," said Dr. Joachim Listing, German Rheumatism Research Centre Berlin, Germany and lead study author. "Our study demonstrates the positive impact that biologic treatment can have on patient's life expectancy.
According to the researchers, a significant association between disease activity and mortality risk was observed by multivariate Cox regression within the patient sample. Cox proportional hazard regression was applied to investigate the influence of the time varying DAS28 scores, functional capacity and treatments on mortality risk after adjustment for age, sex, eight co-morbid conditions and smoking. The primary analysis was based on a risk window approach assuming the patient was exposed to biologic DMARD treatment up to six months (12 months for rituximab) after the last dose. Mean observation time was 3.5 years.
Results of a separate study show that early remission is associated to better overall survival.
Results of a large observational study presented at EULAR show early and sustained remission are associated with a decreased all-cause mortality in patients in inflammatory polyarthritis. The analyses from the Norforlk arthritis register, a large population-based inception cohort of inflammatory polyarthritis established in 1990, showed that achieving remission at least once within the first three years of follow-up was associated with improved survival (adjusted HR=0.75 (0.59, 0.95), 95% CI). Number of times in remission was also associated with decreased all-cause mortality. Patients who were in remission for one year after their first assessment had the greatest reduction in mortality risk compared to patients who didn't achieve remission within the first three years (adjusted HR=0.66 (0.47, 0.92)), while patients who achieved remission at year two or three showed a progressive loss of the beneficial effect of achieving remission. This indicates that achieving remission at an early stage in the disease process is essential to improving outcome for patients with polyarthritis.
Abstract Number: OP0047, OP0126
*HAQ DI (Health Assessment Questionnaire – Disease Index) is a patient questionnaire that measures function and health-related quality of life through measuring a patient's ability to perform everyday tasks.
NOTES TO EDITORS:
For further information on this study, or to request an interview with the study lead, please do not hesitate to contact the EULAR congress Press Office in Hall 6 on the 3rd floor of the Congress Centre during EULAR 2012 or on:
Email: eularpressoffice@cohnwolfe.com
Candice Debleu:
Onsite tel: +44 7894 386 425
About EULAR
- The European League Against Rheumatism (EULAR) is the organisation which represents the patient, health professional and scientific societies of rheumatology of all the European nations
- In line with The European Union of Medical Specialists (UEMS), EULAR defines rheumatology as including rheumatic diseases of the connective tissue, locomotor and musculoskeletal systems
- EULAR aims to promote, stimulate and support the research, prevention, treatment and rehabilitation of rheumatic diseases. With 45 scientific member societies, 36 PARE organisations and 10 health professionals associations, EULAR underscores the importance of combating rheumatic diseases not only by medical means, but also through a wider context of care for rheumatic patients and a thorough understanding of their social and other needs
- Diseases of the bone and joints such as rheumatoid arthritis and osteoarthritis cause disability in 4-5% of the adult population and are predicted to rise as people live longer
- EULAR 2012 is set to be the biggest rheumatology event in Europe with over 15,000 scientists, physicians, allied health professionals, and related audiences in attendance from over 115 countries. Over the course of the congress, more than 275 oral and 1400 poster abstract presentations will be featured, with 1,010 invited speaker lectures taking place in 190 sessions
- To find out more about the activities of EULAR, visit: www.eular.org
Journal
Annals of the Rheumatic Diseases