Abstract | OBJECTIVE: METHODS: Eligible patients with established RA were identified through administrative claims data linked to laboratory results (2005-2016). Patients were categorized by positivity status for ACPA, RF, or both. Patients were further divided into groups by autoantibody titers. DMARD-exposed patients were categorized into biologic DMARD (bDMARD) and conventional DMARD (cDMARD) subcohorts. Crude mortality rates/1,000 patient-years and Kaplan-Meier curves were compared between antibody categories. Adjusted Cox proportional hazards regression and sensitivity (propensity-matched patients) analyses were conducted. RESULTS: Overall, 53,849 and 79,926 patients had evaluable ACPA and RF status, respectively. For both autoantibodies, mortality rates were significantly higher in seropositive versus seronegative patients (risk increase of 48.0% and 44.0% in ACPA- and RF-positive patients, respectively; P < 0.001 each). Mortality rates were greatest in patients with higher versus lower autoantibody titers (ACPA hazard ratio [HR] 1.60 [95% confidence interval (95% CI]) 1.45-1.76]; RF HR 1.78 [95% CI 1.66-1.91]). In cDMARD-exposed patients, HRs were higher in seropositive versus seronegative cohorts; in bDMARD-exposed patients, there was no difference in mortality by serostatus. CONCLUSION: Elevated ACPA/RF titers were independently associated with increased mortality among patients with RA and persisted in patients treated with cDMARDs but not with bDMARDs.
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Authors | Evo Alemao, Ying Bao, Michael E Weinblatt, Nancy Shadick |
Journal | Arthritis care & research
(Arthritis Care Res (Hoboken))
Vol. 72
Issue 2
Pg. 176-183
(02 2020)
ISSN: 2151-4658 [Electronic] United States |
PMID | 31529682
(Publication Type: Journal Article, Pragmatic Clinical Trial, Research Support, Non-U.S. Gov't)
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Copyright | © 2019, Bristol Myers Squibb. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology. |
Chemical References |
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Topics |
- Aged
- Aged, 80 and over
- Antirheumatic Agents
(therapeutic use)
- Arthritis, Rheumatoid
(blood, drug therapy, mortality)
- Databases, Factual
(trends)
- Female
- Humans
- Male
- Middle Aged
- Mortality
(trends)
- Retrospective Studies
- Treatment Outcome
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