Mortality in early "sawtooth" treated rheumatoid arthritis patients during the first 8-14 years

Scand J Rheumatol. 1999;28(5):282-7. doi: 10.1080/03009749950155463.


Objective: To describe mortality in a cohort of early RA patients treated from the onset with disease-modifying antirheumatic drugs (DMARDs) according to the 'sawtooth' strategy.

Patients and methods: A total of 135 early RA patients were followed up for 8-14 years or until death. Causes of death were checked on the death certificates and in patient files. Standardized mortality ratio (SMR) was calculated. Results. A total of 25 (14F, 11M) patients died during the 1422 person-years of follow-up. The SMR (95%CI) was 1.28 (0.83-1.89); 1.69 (0.92-2.82) for women and 0.98 (0.49-1.74) for men. In five cases death was closely related to RA. No one died from amyloidosis. Not a single death was caused by DMARDs in spite of extensive use of these drugs. Patient's age at the start was the only statistically significant predictor for death.

Conclusion: Despite active treatment with available DMARDs, RA seems still to be a fatal disease in a proportion of cases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Antirheumatic Agents / adverse effects
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / mortality*
  • Cause of Death
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Time Factors


  • Adrenal Cortex Hormones
  • Antirheumatic Agents