NEW YORK (Reuters Health) - The rates of hospitalization to treat severe complications of rheumatoid arthritis (RA) declined between 1983 and 2001, according to an investigator at the US National Institute of Arthritis and Musculoskeletal and Skin Diseases.
"These findings suggest that since the early 1980s, the long-term health outcomes of patients with RA have improved," Dr. Michael M. Ward reports in the medical journal Arthritis and Rheumatism.
The Bethesda, Maryland-based researcher identified people with RA age 40 or older using the data files of the California Office of Statewide Health Planning and Development. He used data to spot indications of severe disease and failure of treatment to adequately control the condition.
For the period from 1983 to 1987, there were 148.7 hospitalizations for rheumatoid vascular inflammation per 100,000 patients with RA. This declined to 97.8 for the period between 1998 and 2001.
Corresponding rates for spleen removal to treat an arthritis-related condition called Felty's syndrome were 6.1 and 1.8 per 100,000.
There were increasing rates of total knee replacement between 1983 and 1997, but this reversed between 1997 and 2001. Ward describes this as "particularly noteworthy," since the rates of knee replacement more than doubled between 1998 and 2000 among Medicare recipients overall.
The investigator says the data suggest that "the decreased rates of hospitalization for manifestations of severe RA were not due to changes in the use of hospital care from 1983 to 2001, but rather were specific to manifestations of RA."
The findings are in line with greater use of disease-modifying medications in the late 1980s and early 1990s, he adds.
However, the decrease predated the widespread use of the latest anti-rheumatic medications. As these drugs are used more often and "more consistently throughout the course of the disease, further improvements in the health outcomes of patients with RA might be anticipated," Ward concludes.
SOURCE: Arthritis and Rheumatism, April 2004.