We studied survival trends over time and risk factors for death in a large population of patients with rheumatoid arthritis (RA) followed over a 40-year period. Patients were all Rochester, MN residents, aged = 18 years of age who first had Rheumatoid Arthritis between January 1, 1965 and December 31, 1994. Patients were followed longitudinally until death or migration from the county. Survival of patients with Rheumatoid Arthritis was compared with expected survival of people of the same sex and age who lived in the same community.

People with Rheumatoid Arthritis had a 27% higher risk of death compared with people of the same age and sex from the same general population. Women with Rheumatoid Arthritis had a 41% higher risk of death while men had only an 8% increased risk. Risk factors most strongly associated with mortality were the presence of Rheumatoid Arthritis disease complications, specifically extra-articular manifestations of disease (i.e. Rheumatoid Arthritis affecting organs other than the joints, e.g. rheumatoid lung) and comorbidities (i.e. diseases other than Rheumatoid Arthritis [such as heart disease or Diabetes] co-occurring in Rheumatoid Arthritis patients). Moreover, our results showed no evidence of improvement in survival among patients with Rheumatoid Arthritis over the past 4-5 decades.

These findings point to the need for more research to identify ways to reduce the excess risk of death among people with Rheumatoid Arthritis and to understand the effects of new Rheumatoid Arthritis treatments on mortality.