ArticleAnnals of the rheumatic diseases2024
Long-term mortality in treated-to-target RA and UA: results of the BeSt and IMPROVED cohort.
Article in Annals of the rheumatic diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Meta-Analysis of the Incidence and Influencing Factors of Malignant Tumors in Patients with Rheumatoid Arthritis.Journal of epidemiology and global health · 2026Pooled it
- Long-term clinical outcomes in early rheumatoid arthritis that was treated-to-target in the BeSt and IMPROVED studies.Rheumatology (Oxford, England) · 2025Trial
- A Phase 1, randomized, double-blind, placebo-controlled, single- and multiple-dose escalation study to evaluate the safety and pharmacokinetics/pharmacodynamics of PF-06835375, a C-X-C chemokine receptor type 5 directed antibody, in patients with systemic lupus erythematosus or rheumatoid arthritis.Arthritis research & therapy · 2024Trial
- Comorbidity and mortality in adults with juvenile idiopathic arthritis: a nationwide Norwegian register-based matched cohort study.Rheumatology (Oxford, England) · 2026Article
- Osteoimmunology: Can We Prevent Bone Loss in Rheumatoid Arthritis with Modern Antirheumatic Drugs?Calcified tissue international · 2026Review
- Differences in Cause-Specific Mortality in Patients With Rheumatoid Arthritis by Sex and Seropositivity.The Journal of rheumatology · 2025Article
- Survival Outcomes and Prognostic Factors in Rheumatoid Arthritis Patients Receiving Biologic or Targeted Synthetic Therapy: Real-World Data.Antibodies (Basel, Switzerland) · 2025Article
- The C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index exhibits an L-shaped association with all-cause mortality in rheumatoid arthritis patients: a retrospective cohort study.BMC rheumatology · 2025Article
- Exploring the causal relationships between rheumatoid arthritis and oral phenotypes: a genetic correlation and Mendelian randomization study.Frontiers in genetics · 2024Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo study long-term (up to 20-year) mortality of two treat-to-target trial cohorts in undifferentiated arthritis (UA) and early rheumatoid arthritis (RA).
methodsThe BeSt (BehandelStrategieën) study (n=508, early RA) was performed between 2000 and 2012. For 10 years, patients were treated-to-target disease activity score (DAS)≤2.4.The Induction therapy with Methotrexate and Prednisone in Rheumatoid Or Very Early arthritic Disease (IMPROVED) study (n=610, early RA/UA) was performed between 2007 and 2015. For 5 years, patients were treated-to-target DAS<1.6.Vital status of BeSt/IMPROVED participants was assessed up to and including 31 December 2021. Standardised mortality ratios (SMRs) were calculated. Stratified analyses for anticitrullinated protein antibody (ACPA) and smoking status were performed. Death causes and the potential effect of disease activity during the trial period on late mortality were assessed.
resultsExcess mortality was found in both BeSt (SMR 1.32, 95% CI 1.14 to 1.53) and IMPROVED (SMR 1.33, 95% CI 1.10 to 1.63) and became manifest after 10 years. Excess mortality was statistically significant in ACPA+ patients who smoked (BeSt: SMR 2.80, 95% CI 2.16 to 3.64; IMPROVED: 2.14, 95% CI 1.33 to 3.45). Mean survival time was 10 (95% CI 5 to 16) months shorter than expected in BeSt and 13 (95% CI 11 to 16) months in IMPROVED. The HR for mortality was 1.34 (95% CI 0.96 to 1.86; BeSt)/1.13 (95% CI 0.67 to 1.91; IMPROVED) per 1 point increase in mean DAS during the trial. The main cause of death was malignancy.
conclusionsAfter long-term treatment-to-target, excess mortality occurred in patients with RA after>10 years since treatment start, with smoking as an important risk factor.
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