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Association of seropositivity and mortality in rheumatoid arthritis and the impact of treatment with disease-modifying antirheumatic drugs: Results from a real-world study

Arthritis Care & Research Jan 23, 2020

Alemao E, et al. - In order to find out the correlation of antibody titers with mortality and its modification by disease-modifying antirheumatic drugs (DMARDs), researchers identified eligible individuals with established RA through administrative claims data linked to laboratory results (2005–2016). They classified individuals by positivity status for ACPA, RF, or both. Further, they classified individuals into groups by autoantibody titers. They divided DMARD-exposed individuals into biologic DMARD (bDMARD) and conventional DMARD (cDMARD) subcohorts. They compared crude mortality rates/1,000 patient-years and Kaplan-Meier curves between antibody categories. They performed adjusted Cox proportional hazards regression and sensitivity (propensity-matched patients) analyses. They observed that 53,849 and 79,926 individuals had evaluable ACPA and RF status, respectively. There was an association between elevated ACPA/RF titers and increased mortality among patients with RA and persisted in patients treated with cDMARDs but not with bDMARDs.
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