RA&Mortality.sav

<b>Objective: </b>The aim of this study is to investigate the causes of mortality in patients diagnosed with rheumatoid arthritis (RA) and the effects of DMARDs to be used in the treatment of RA on mortality. <b>Material and Method: : </b>A total of 743 RA patients over the age of 18 who attended between 2010 and 2020 in the hospital where this study was conducted, were included in the study. The patients' clinical and laboratory were obtained from the hospital database, whereas the relevant mortality and population data were obtained from the Turkish Ministry of Health system and the Turkish Statistical Institute, respectively. The standardized mortality ratio (SMR) was calculated by dividing the number of mortalities observed in the cohort by the number of mortalities in the Turkish population of the same age and gender. Patients were divided into two groups: those who only use only conventional disease-modifying antirheumatic drugs (cDMARDs) and those who take cDMARDs plus biologic disease-modifying antirheumatic drugs (bDMARDs). Head-to-head comparisons were made in terms of mortalities both between the said groups and within the group of patients that use bDMARDs. <b>Results: </b>Mortality occurred in 61 patients from among the<b> </b>743 RA patients followed up between 2010 and 2020. SMR of the RA patients was found to be 1.42 [(CI (confidence interval) 1.09-1.81)] in the Turkish population. SMR was determined to be higher in the cDMARD cohort than in the bDMARD cohort [2.05 (CI 1.53-2.69) and 0.66 (CI 0.37-1.11), respectively]. The most common causes of mortality in RA patients were determined as cardiovascular diseases 18 (29.5%), infectious diseases 13 (21.3%) and respiratory system diseases 12 (19.7%). The mortality rate due to infectious diseases was determined to be higher in the bDMARD cohort as compared to the cDMARD cohort (30.8% vs 18.8%), whereas the mortality rate due to cardiovascular causes was determined to be higher in the cDMARD cohort as compared to the bDMARD cohort (31.3% vs. 23.1%), albeit not statistically significantly in either of the cases. <b>Conclusion:</b> This study is the first mortality study reported from Turkey in patients with a diagnosis of RA. The results of this study indicated that the SMR of RA patients is higher than the SMR observed in the general Turkish population. Therefore, in order to reduce mortality in patients with RA, RA patients should be followed more carefully, and treated more effectively in terms of both RA and any comorbid diseases they might have.<br>