Rheumatoid Arthritis Disease Activity and Mortality Risk with Pneumonia

by Lauren Taylor from In The Cloud Copy

Rheumatoid arthritis (RA) is an autoimmune inflammatory disorder that causes inflammation to the lining of your joints while also causing damage to other parts of your body. RA is caused when the body attacks the synovium, or the lining of the membranes surrounding the joints, causing inflammation and destruction. Symptoms of RA may include fatigue, fever, joint stiffness, and warm, swollen, or tender joints. About 40% of those with joint symptoms also experience signs and symptoms that don’t involve the joints, such as symptoms involving the skin, eyes, lungs, heart, and more. People with RA are at an increased risk of complications, some serious. These complications can include osteoporosis, dry eyes and mouth, infections, heart problems, lung disease, and lymphoma.

Pneumonia Complications in the RA Population

Pneumonia is a common illness that circulates around the population, particularly in the winter months. While it is a serious infection, it is usually treatable in the general, healthy population. Patients with RA have a greater risk of death from pneumonia and the reason isn’t exactly clear. Is it because of their increased risk of acquiring infections in general? Or is it that once they have pneumonia, they are less able to recover?

Researching the Effects of RA on Pneumonia Outcomes

A team of researchers from Aarhus University Hospital in Aarhus, Denmark gathered and analyzed data to better understand what is causing patients with RA to experience worse outcomes from pneumonia than the general population. They collected data on 52,577 hospitalized patients and 1,220 of those patients had a diagnosis of RA. What they found was that was that after 90 days, the mortality rates for patients with a diagnosis of RA were 19.9%, while the mortality rates for patients without RA were 18.9%. This data showed that a diagnosis of RA had very little impact on mortality.

Researchers looked further, analyzing whether the treatments that patients were using for the RA had any further impact on mortality rates. They found that treatment did not seem to have any impact on increased mortality rates from pneumonia.

What they did find was that patients that were not receiving any RA treatment – whether because they are in remission or because they have totally uncontrolled disease – did have a higher 90-day mortality rate than patients that were being treated with methotrexate monotherapy (a common treatment for RA). Further, patients who had recently used prednisolone, a steroid often used to control flare-ups of RA disease, did have a higher mortality rate than those who had not recently used.

The C reactive protein (CRP) levels are a lab indicator of disease activity in patients with RA. Researchers found that patients with high CRP level (greater than or equal to 20 mg/L) had a higher 90-day mortality rate than those patients with a CRP level of less than 8 mg/L.

What this shows is that controlling disease activity is the most important factor in good outcomes for patients with infections like pneumonia.

Learn more about this research here.

Check out the original study here.

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