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High disability after a year of RA treatment signals increased mortality risk

Key clinical point: The findings suggest that poorer disease control (high Disease Activity Score in 28 joints) within the first treatment year for RA may lead to increased disability (high Health Assessment Questionnaire Disability Index scores) which in turn may contribute to higher mortality.

Major finding: A high Health Assessment Questionnaire Disability Index score at 1 year increased the risk of all-cause mortality by 87% in a multivariate, discrete-time survival model that adjusted for age, gender, comorbidities, disease activity, smoking, education, seropositivity, symptom duration, and glucocorticoid use.

Study details: An observational study of 1,724 patients with RA who had a symptom duration of less than 1 year at the time of enrollment in the Canadian Early Arthritis Cohort during 2007-2017.

Disclosures: The Canadian Early Arthritis Cohort has been funded over many years by multiple companies including Amgen and Pfizer Canada, AbbVie, Medexus, Eli Lilly Canada, Merck Canada, Sandoz, Hoffman–La Roche, Janssen, UCB Canada, Bristol-Myers Squibb Canada, and Sanofi Genzyme. The authors had no disclosures.


Fatima S et al. Arthritis Rheumatol. 2020 Sep 6. doi: 10.1002/art.41513.