title: Life expectancies of Japanese patients with rheumatoid arthritis: a review of deaths over a 20-year period.
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.
authors.affiliation: Centre for Rheumatic Disease, Mima Hospital in Yoshinogawa City, Yoshinogawa, Japan. ayutarou@mima-gr.jp
authors.forename: Fumio
authors.initials: F
authors.lastname: Shinomiya
authors.forename: Noriaki
authors.initials: N
authors.lastname: Mima
authors.forename: Keiichirou
authors.initials: K
authors.lastname: Nanba
authors.forename: Kenji
authors.initials: K
authors.lastname: Tani
authors.forename: Shunji
authors.initials: S
authors.lastname: Nakano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Egawa
authors.forename: Toshinori
authors.initials: T
authors.lastname: Sakai
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyoshi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hamada
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy; D002423:Cause of Death; D005260:Female; D006801:Humans; D008017:Life Expectancy / Q000639:trends*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D015996:Survival Rate
chemical_list: D018501:Antirheumatic Agents