Patients with inflammatory polyarthritis had decreased numbers of swollen joints compared with patient populations 10 years earlier, but the number of tender joints, functional disability levels, and mortality were unchanged, according to a study published in the Annals of the Rheumatic Diseases.
Patients with inflammatory polyarthritis were recruited from 1990 to 1994 (n=1022) and from 2000 to 2004 (n=631), and researchers compared the 10-year clinical outcomes in both cohorts. Measurements of swollen join counts, tender joint counts, functional disability, and mortality were collected at baseline and at 1, 3, 5, 7 and 10 years, and compared in both groups.
In the participants recruited from 2000 to 2004, patients were older at symptom onset, had longer symptom duration, and had higher functional disability at baseline. After 10 years, the participants from this cohort had decreased numbers of swollen joints compared with the previous decade. However, no significant differences were found for tender joint counts, functional disability, or mortality. Secondary outcomes examining medication use revealed that participants in the later cohort were taking more oral steroids and disease-modifying antirheumatic drugs (DMARDs) than participants from the earlier cohort. The researchers note that this result was not unexpected due to new treatment options developed over the past 2 decades.
The study investigators wrote, “Our analysis did not demonstrate a significant reduction in 10-year mortality in patients with early [inflammatory polyarthritis]… results are in line with a study of patients with RA [rheumatoid arthritis] from Ontario, Canada, which reported no significant change in [mortality rate ratios] over the period 1996-2009.”
Gwinnutt J, Symmons D, MacGregor A, et al. Have the 10-year outcomes of patients with early inflammatory arthritis improved in the new millennium compared with the decade before? [published online February 23, 2018]. Ann Rheum Dis. doi:10.1136/annrheumdis-2017-212426