The mortality of rheumatoid vasculitis compared with rheumatoid arthritis.

OBJECTIVE

To determine whether the mortality of patients with rheumatoid vasculitis (RV) is increased in comparison with that of patients with rheumatoid arthritis (RA).

METHODS

The mortality of all RV patients identified in 1980-1992 (n=61) was compared with that of 244 RA controls matched for the year the diagnosis was made in the RV cases. Hazard ratios (HR) of death were calculated with a multivariate survival analysis, adjusting for age, sex, comorbidity, treatment, and parameters of RA severity.

RESULTS

The unadjusted risk of death (HR) in RV patients compared with RA controls was 1.65 (95% confidence interval [95% CI] 1.05-2.58). After adjustment for prognostic factors, the HR was reduced to 1.26 (95% CI 0.79-2.01), mainly due to removal of the effects of age and sex. No excess mortality was seen in RV patients with severe organ involvement when compared with RV patients without severe organ involvement, although the former patients were treated more often with cytostatic and immunosuppressive drugs. Infection was the main cause of death in the RV patients, and cardiovascular disease in the RA controls. Vasculitis was reported as the cause of death in only 1 RV patient.

CONCLUSION

After allowance for general risk factors such as age and sex, there remains only a slight excess mortality in RV patients compared with RA controls.