Original Article

Life expectancies of Japanese patients with rheumatoid arthritis: a review of deaths over a 20-year period

Authors

Fumio Shinomiya¹, Noriaki Mima¹, Keiichirou Nanba¹, Kenji Tani², Shunji Nakano³, Hiroshi Egawa³, Toshinori Sakai³, Hideaki Miyoshi³ and Daisuke Hamada³

1. Centre for Rheumatic Disease, Mima Hospital in Yoshinogawa City, 494 Kamojima Jougejima, Yoshinogawa 776-0013, Japan
2. Department of Internal Medicine and Molecular Therapy, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
3. Department of Orthopaedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan

Received:

18 May 2007

Accepted:

12 November 2007

Published online:

4 March 2008

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Abstract

We investigated trends in life expectancy in rheumatoid arthritis (RA) patients, reviewing records for 286 patients (204 female, 82 male) who had died over the past 20 years. The average age at death was 68.8 years before 1990, increasing to 72.1 years after 2001. Trends in disease modifying anti-rheumatic drugs (DMARDs) saw gold preparations (45.2%) predominate before 1990, sulphydryl donor agents (53.6%) from 1991 to 2000, then methotrexate (43.0%) after 2001. The most common causes of death were infectious diseases up to 1995, rheumatic disease 1996−2000, and cardiovascular events and malignancies after 2001. Major advances in surgical interventions, such as joint replacement surgery, occurred after 1990. Surgical intervention followed by a period of rehabilitation maintained a favourable level of activities of daily living (ADLs), The requirements for favourable life expectancy are control of RA inflammation and maintenance of a favourable level of ADLs. Although recently developed DMARDs and biological agents show promise, caution is required to avoid serious adverse reactions. Optimum care of patients with RA will require preventive measures and early intervention for infections and rheumatic diseases, as well as for lifestyle diseases, osteoporosis and malignancies.

Key words

Activities of daily living - Disease modifying anti-rheumatic drug - Life expectancy - Rheumatoid arthritis