title: Cause-Specific Mortality in Male US Veterans With Rheumatoid Arthritis.
abstract: OBJECTIVE
  There has been limited investigation into cause-specific mortality and the associated risk factors in men with rheumatoid arthritis (RA). We investigated all-cause and cause-specific mortality in men with RA, examining determinants of survival.
  
  
  METHODS
  Men from a longitudinal RA registry were followed from enrollment until death or through 2013. Vital status and cause of death were determined using the National Death Index. Crude mortality rates and standardized mortality ratios (SMRs) were calculated for all-cause, cardiovascular disease (CVD), cancer, and respiratory mortality. Associations with all-cause and cause-specific mortality were examined using multivariable Cox proportional hazards and competing-risks regression.
  
  
  RESULTS
  There were 1,652 men with RA and 332 deaths. The leading causes of death were CVD (31.6%; SMR 1.77 [95% confidence interval (95% CI) 1.46-2.14]), cancer (22.9%; SMR 1.50 [95% CI 1.20-1.89]), and respiratory disease (15.1%; SMR 2.90 [95% CI 2.20-3.83]). Factors associated with all-cause mortality included older age, white race, smoking, low body weight, comorbidity, disease activity, and prednisone use. Rheumatoid factor concentration and nodules were associated with CVD mortality. There were no associations of methotrexate or biologic agent use with all-cause or cause-specific mortality.
  
  
  CONCLUSIONS
  Men in this RA cohort experienced increased all-cause and cause-specific mortality, with a 3-fold risk of respiratory-related deaths compared to age-matched men in the general population. Further studies are needed in order to examine whether interventions targeting potentially modifiable correlates of mortality might lead to improved long-term survival in men with RA.
authors.affiliation: Veterans Affairs Nebraska-Western Iowa Health Care System, and University of Nebraska Medical Center, Omaha.
authors.forename: Bryant R
authors.initials: BR
authors.lastname: England
authors.affiliation: Veterans Affairs Nebraska-Western Iowa Health Care System, and University of Nebraska Medical Center, Omaha.
authors.forename: Harlan
authors.initials: H
authors.lastname: Sayles
authors.affiliation: Veterans Affairs Nebraska-Western Iowa Health Care System, University of Nebraska Medical Center, Omaha, and National Data Bank for Rheumatic Diseases, Wichita, Kansas.
authors.forename: Kaleb
authors.initials: K
authors.lastname: Michaud
authors.affiliation: Denver VAMC and University of Colorado, Denver.
authors.forename: Liron
authors.initials: L
authors.lastname: Caplan
authors.affiliation: Denver VAMC, University of Colorado, and Denver Health Medical Center, Denver, Colorado.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Davis
authors.affiliation: Veterans Affairs Salt Lake City Health Care System and University of Utah School of Medicine, Salt Lake City.
authors.forename: Grant W
authors.initials: GW
authors.lastname: Cannon
authors.affiliation: Veterans Affairs Salt Lake City Health Care System and University of Utah School of Medicine, Salt Lake City.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Sauer
authors.affiliation: Dallas Veterans Affairs and University of Texas Southwestern, Dallas.
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Solow
authors.affiliation: Dallas Veterans Affairs and University of Texas Southwestern, Dallas.
authors.forename: Andreas M
authors.initials: AM
authors.lastname: Reimold
authors.affiliation: Washington, DC, Veterans Affairs Medical Center and Georgetown and Howard Universities, Washington, DC.
authors.forename: Gail S
authors.initials: GS
authors.lastname: Kerr
authors.affiliation: Portland Veterans Affairs Health Care System and Oregon Health and Sciences University, Portland.
authors.forename: Pascale
authors.initials: P
authors.lastname: Schwab
authors.affiliation: Philadelphia VAMC and University of Pennsylvania School of Medicine, Philadelphia.
authors.forename: Josh F
authors.initials: JF
authors.lastname: Baker
authors.affiliation: Veterans Affairs Nebraska-Western Iowa Health Care System, and University of Nebraska Medical Center, Omaha.
authors.forename: Ted R
authors.initials: TR
authors.lastname: Mikuls
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D015897:Comorbidity; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012140:Respiratory Tract Diseases / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D058014:Veterans Health
chemical_list: D018501:Antirheumatic Agents