Seropositivity Increases Risk of Rheumatoid Mortality Save

Three European registries analyzed their cohorts for outcomes that may be related to seropositivity for anticitrullinated protein antibodies (ACPA), rheumatoid factor (RF) and anticarbamylated protein (anti-CarP) antibodies.

2331 patients with early RA that were followed in the Better Anti-Rheumatic Farmaco-Therapy cohort (BARFOT) (n=805), Norfolk Arthritis Register (NOAR) (n=678) and Leiden Early Arthritis Clinic cohort (EAC) (n=848) were studied for all-cause and cause-specific mortality.

With 26 300 person-years of observation, 29% of BARFOT patients, 30% of NOAR and 18% of EAC patients died. The all-cause mortality (HR, 95% CI) was increased for all 3 autoantibodies; 1.48 (1.22 to 1.79) for ACPA, 1.47 (1.22 to 1.78) for RF and 1.33 (1.11 to 1.60) for anti-CarP.

ACPA positivity associated with increased cardiovascular death (HR 1.52; 1.04 to 2.21), and RF was associated with with increased neoplasm-related death (HR 1.64; 1.02 to 2.62), and respiratory disease-related deaths (HR 1.71;1.01 to 2.88).