@article{2999719,
    title = "All-cause mortality in systemic rheumatic diseases under treatment compared with the general population, 2015-2019",
    author = "Bournia, V.-K. and Fragoulis, G.E. and Mitrou, P. and Mathioudakis, K. and Tsolakidis, A. and Konstantonis, G. and Vourli, G. and Paraskevis, D. and Tektonidou, M.G. and Sfikakis, P.P.",
    journal = "RMD Open: Rheumatic & Musculoskeletal Diseases",
    year = "2021",
    volume = "7",
    number = "3",
    publisher = "BMJ Publishing Group",
    issn = "2056-5933",
    doi = "10.1136/rmdopen-2021-001694",
    keywords = "disease modifying antirheumatic drug, adult;  age;  aged;  all cause mortality;  ankylosing spondylitis;  Article;  clinical practice;  cohort analysis;  comorbidity;  comparative study;  demographics;  disease duration;  disease severity;  female;  follow up;  Greece;  human;  ICD-10;  major clinical study;  male;  population research;  prescription;  psoriatic arthritis;  retrospective study;  rheumatoid arthritis;  social status;  survival analysis;  survival rate;  systemic lupus erythematosus;  systemic sclerosis;  middle aged;  psoriatic arthritis;  rheumatic disease;  rheumatoid arthritis;  systemic lupus erythematosus, Arthritis, Psoriatic;  Arthritis, Rheumatoid;  Female;  Humans;  Lupus Erythematosus, Systemic;  Male;  Middle Aged;  Retrospective Studies;  Rheumatic Diseases",
    abstract = "Objectives To compare current all-cause mortality rates in rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) versus general population. Methods In this population-based, retrospective cohort study, anonymised data on 11 186 586 citizens, including all patients with RA (42 735, 79% female), AS (9707, 43% female), PsA (13 779, 55% female), SLE (10 440, 89% female) and SSc (2277, 88% female), (median age of 64/47/54/53/59 years at study entry, respectively), under prescribed treatment between 2015 and 2019, were extracted from the electronic database covering nearly 99% of the Greek population. Results After 1:5 (patients:general population) matching for gender/age, we found that survival was worse in SSc, followed by SLE and inflammatory arthritis. Compared with the general population HRs for death increased from the first 3 years to 5 years of observation possibly due to increases in disease duration: RA (from 0.63 to 1.13 (95% CI: 1.05 to 1.22), AS (from 0.62 to 1.01, (95% CI: 0.76 to 1.33)), PsA (from 0.68 to 1.06, (95% CI: 0.88 to 1.28)), SLE (from 1.52 to 1.98, (95% CI: 1.67 to 2.33)) and SSc (from 2.27 to 4.24, (95% CI: 3.19 to 5.63)). In both SLE and SSc mortality was increased in men than women and in patients younger than 50 years. Conclusions Survival rates over 5 years in inflammatory arthritis under treatment are currently becoming comparable (AS/PsA) or slightly higher (RA) than those of the general population. However, all-cause mortality is almost twofold and fourfold higher in SLE and SSc, respectively, being even higher for male and younger patients. ©"
}