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Prati C, Puyraveau M, Guillot X, Verhoeven F, Wendling D. Deaths Associated with Ankylosing Spondylitis in France from 1969 to 2009. J Rheumatol 2017; 44:594-598. [PMID: 28298562 DOI: 10.3899/jrheum.160942] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To describe deaths for which ankylosing spondylitis (AS) was on death certificates in France. METHODS Death certificates in which AS was indicated were evaluated. Standard mortality ratio (SMR) was assessed. RESULTS AS appeared in 2940 death certificates. The mortality rate of AS seemed stable. The most frequent initial causes were diseases of the circulatory system [28.3% in the International Classification of Diseases, 10th ed (ICD-10)]. SMR adjusted for age and sex were 2.1 (95% CI 1.45-2.91) for infections and 0.43 (0.36-0.5) for cancers (ICD-10 period). CONCLUSION This study found an increase in mortality from infectious and external causes of death; conversely, patients with AS appear to die less frequently from cancer.
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Affiliation(s)
- Clément Prati
- From the Department of Rheumatology, CHU Besançon; FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; Centre de Méthodologie Clinique, CHU Besançon; EA 4266 Agents pathogènes et inflammation, Université de Bourgogne Franche-Comté, Besançon, France. .,C. Prati, MD, PhD, Department of Rheumatology, CHU Besançon, and FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; M. Puyraveau, PhD, Centre de Méthodologie Clinique, CHU Besançon; X. Guillot, MD, Department of Rheumatology, CHU Besançon, and FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; F. Verhoeven, MD, Department of Rheumatology, CHU Besançon, and FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; D. Wendling, MD, PhD, Professor, Department of Rheumatology, CHU Besançon, and EA 4266 Agents pathogènes et inflammation, Université de Bourgogne Franche-Comté.
| | - Marc Puyraveau
- From the Department of Rheumatology, CHU Besançon; FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; Centre de Méthodologie Clinique, CHU Besançon; EA 4266 Agents pathogènes et inflammation, Université de Bourgogne Franche-Comté, Besançon, France.,C. Prati, MD, PhD, Department of Rheumatology, CHU Besançon, and FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; M. Puyraveau, PhD, Centre de Méthodologie Clinique, CHU Besançon; X. Guillot, MD, Department of Rheumatology, CHU Besançon, and FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; F. Verhoeven, MD, Department of Rheumatology, CHU Besançon, and FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; D. Wendling, MD, PhD, Professor, Department of Rheumatology, CHU Besançon, and EA 4266 Agents pathogènes et inflammation, Université de Bourgogne Franche-Comté
| | - Xavier Guillot
- From the Department of Rheumatology, CHU Besançon; FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; Centre de Méthodologie Clinique, CHU Besançon; EA 4266 Agents pathogènes et inflammation, Université de Bourgogne Franche-Comté, Besançon, France.,C. Prati, MD, PhD, Department of Rheumatology, CHU Besançon, and FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; M. Puyraveau, PhD, Centre de Méthodologie Clinique, CHU Besançon; X. Guillot, MD, Department of Rheumatology, CHU Besançon, and FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; F. Verhoeven, MD, Department of Rheumatology, CHU Besançon, and FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; D. Wendling, MD, PhD, Professor, Department of Rheumatology, CHU Besançon, and EA 4266 Agents pathogènes et inflammation, Université de Bourgogne Franche-Comté
| | - Franck Verhoeven
- From the Department of Rheumatology, CHU Besançon; FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; Centre de Méthodologie Clinique, CHU Besançon; EA 4266 Agents pathogènes et inflammation, Université de Bourgogne Franche-Comté, Besançon, France.,C. Prati, MD, PhD, Department of Rheumatology, CHU Besançon, and FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; M. Puyraveau, PhD, Centre de Méthodologie Clinique, CHU Besançon; X. Guillot, MD, Department of Rheumatology, CHU Besançon, and FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; F. Verhoeven, MD, Department of Rheumatology, CHU Besançon, and FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; D. Wendling, MD, PhD, Professor, Department of Rheumatology, CHU Besançon, and EA 4266 Agents pathogènes et inflammation, Université de Bourgogne Franche-Comté
| | - Daniel Wendling
- From the Department of Rheumatology, CHU Besançon; FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; Centre de Méthodologie Clinique, CHU Besançon; EA 4266 Agents pathogènes et inflammation, Université de Bourgogne Franche-Comté, Besançon, France.,C. Prati, MD, PhD, Department of Rheumatology, CHU Besançon, and FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; M. Puyraveau, PhD, Centre de Méthodologie Clinique, CHU Besançon; X. Guillot, MD, Department of Rheumatology, CHU Besançon, and FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; F. Verhoeven, MD, Department of Rheumatology, CHU Besançon, and FDE EA4267, (FHU INCREASE) Université de Bourgogne Franche-Comté; D. Wendling, MD, PhD, Professor, Department of Rheumatology, CHU Besançon, and EA 4266 Agents pathogènes et inflammation, Université de Bourgogne Franche-Comté
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Prati C, Claudepierre P, Pham T, Wendling D. Mortality in spondylarthritis. Joint Bone Spine 2011; 78:466-70. [PMID: 21450507 DOI: 10.1016/j.jbspin.2011.02.012] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2010] [Indexed: 11/29/2022]
Abstract
Ankylosing spondylitis (AS) is a chronic inflammatory joint disease that can lead to chronic pain in axial and peripheral joints and to functional impairments after several years. Excess mortality has been reported in patients with AS. We reviewed recent studies of patients with AS who were treated and monitored according to the improved methods developed in the past few years, without radiation therapy. Our results do not support excess mortality in these patients. Long-term follow-up data from patients enrolled in biologics registries will provide additional information. Cardiovascular disease is the leading cause of death in patients with AS, as in the general population. However, the cardiovascular mortality rate may be slightly increased in patients with AS, probably as a result of dyslipidemia and early endothelial dysfunction. Similarly, and as expected, there is excess mortality related to the spinal disease itself and to renal and gastrointestinal disease. More surprisingly, alcohol abuse and injury or suicide cause excess mortality compared to the general population. In the absence of radiation or radium-224 therapy, and regardless of the other treatments used, the evidence does not support an increased rate of lymphoma or other malignancies compared to the general population. In this review, we discuss the causes and rates of mortality in patients with AS.
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Affiliation(s)
- Clément Prati
- Service de rhumatologie, université de Franche-Comté, CHU, 1, boulevard Fleming, 25030 Besançon, France
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