TY - JOUR
T1 - Mortality in patients with incident rheumatoid arthritis and depression
T2 - A Danish cohort study of 11,071 patients and 55,355 comparators
AU - Pedersen, Jens K
AU - Wang, Lei
AU - Risbo, Nickolaj
AU - Pedersen, Alma B
AU - Andersen, Kjeld
AU - Ellingsen, Torkell
PY - 2024/3
Y1 - 2024/3
N2 - OBJECTIVES: In patients with RA, the association between mortality and depression has been investigated only in patients with prevalent RA. In this study, we estimated the mortality risk associated with depression, defined as the first filling of a prescription for antidepressants, in patients with incident RA and background population comparators.METHODS: From 2008 to 2018, we identified patients with incident RA in the nationwide Danish rheumatologic database, DANBIO. For each patient, we randomly selected five comparators. Participants were not treated with antidepressants or diagnosed with depression three years prior to the index date. From other registers we collected data on socioeconomic status, mortality, and cause of death using unique personal identifiers. Using Cox models, we calculated hazard rate ratios (HRR) with 95% CI.RESULTS: In depressed patients with RA versus patients without depression, adjusted HRR for all-cause mortality was 5.34 (95% CI 3.02, 9.45) during 0-2 years and 3.15 (95% CI 2.62, 3.79) during the total follow-up period, and highest in patients <55 years with HRR 8.13 (95% CI 3.89, 17.02). In comparators with depression versus comparators without depression, the association with mortality was similar to that in patients with RA. There were no unnatural causes of death among depressed patients with RA. The most frequent natural causes of death were cancer, cardiovascular disease, stroke, and pneumonia.CONCLUSION: In patients with RA, depression was a predictor of death but with a strength similar to that in matched comparators.
AB - OBJECTIVES: In patients with RA, the association between mortality and depression has been investigated only in patients with prevalent RA. In this study, we estimated the mortality risk associated with depression, defined as the first filling of a prescription for antidepressants, in patients with incident RA and background population comparators.METHODS: From 2008 to 2018, we identified patients with incident RA in the nationwide Danish rheumatologic database, DANBIO. For each patient, we randomly selected five comparators. Participants were not treated with antidepressants or diagnosed with depression three years prior to the index date. From other registers we collected data on socioeconomic status, mortality, and cause of death using unique personal identifiers. Using Cox models, we calculated hazard rate ratios (HRR) with 95% CI.RESULTS: In depressed patients with RA versus patients without depression, adjusted HRR for all-cause mortality was 5.34 (95% CI 3.02, 9.45) during 0-2 years and 3.15 (95% CI 2.62, 3.79) during the total follow-up period, and highest in patients <55 years with HRR 8.13 (95% CI 3.89, 17.02). In comparators with depression versus comparators without depression, the association with mortality was similar to that in patients with RA. There were no unnatural causes of death among depressed patients with RA. The most frequent natural causes of death were cancer, cardiovascular disease, stroke, and pneumonia.CONCLUSION: In patients with RA, depression was a predictor of death but with a strength similar to that in matched comparators.
KW - RA
KW - antidepressive agents
KW - cohort studies
KW - depression
KW - mortality
KW - Denmark/epidemiology
KW - Depression/epidemiology
KW - Humans
KW - Antidepressive Agents/therapeutic use
KW - Arthritis, Rheumatoid/drug therapy
KW - Cohort Studies
UR - http://www.scopus.com/inward/record.url?scp=85186745436&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/kead259
DO - 10.1093/rheumatology/kead259
M3 - Journal article
C2 - 37252810
SN - 1462-0324
VL - 63
SP - 680
EP - 688
JO - Rheumatology
JF - Rheumatology
IS - 3
ER -