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Prognosis and Assessment

Crowson CS, Liang KP, Therneau TM et al.

 Arthritis Rheum 2010;62:378–82.

Rheumatoid arthritis (RA) patients experience increased mortality compared with the general population. Using a large inception cohort, Crowson et al. demonstrated that this excess mortality is caused by premature aging. Moreover, the premature aging is already present before clinical disease-onset illustrating the concept that senescence of immune abnormalities occur before symptoms start in RA.


This study evaluated whether accelerated aging accounts for the increased mortality observed in rheumatoid arthritis (RA) patients compared with the general population. A population-based inception cohort of 755 patients with seropositive RA (mean age 55.6 years, 69% women) who fulfilled 1987 American College of Rheumatology (ACR) criteria for RA was followed for a mean of 12.5 years, during which 315 patients died. The expected mortality rate was obtained by applying the death rates from the general population to the age, sex, and calendar year distribution of the RA population, while the observed mortality was determined using Kaplan–Meier statistical methods.

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