Early, intensive treatment of rheumatoid arthritis can, in the long-term, bring mortality rates for RA patients in line with those rates in the general population. That’s according to the results of a 23-year, follow-up study presented on June 13 in Amsterdam at the Annual European Congress of Rheumatology.

“Our results confirm that early, intensive treatment of rheumatoid arthritis, including use of
glucocorticoids, has long-term benefits,” said study author Maarten Boers, of Amsterdam’s VU University Medical Center, in a news release. “Importantly, this study is one of the first to show a normalization of rheumatoid arthritis mortality compared to the general population after 23 years of follow-up.”

The chairman of EULAR’s scientific program committee, Robert Landewé, noted in the release that it’s well known that negative effects of RA only become fully apparent after a decade. “It is really interesting to see these data supporting early therapy after such a long period of follow-up,” he said.

The study examined mortality rates after 23 years of follow-up on the COBRA trial, in which early rheumatoid arthritis patients received sulfasalazine (azulfidine) or a combination of that drug, low doses of methotrexate, and tapering doses of prednisolone. Results suggested the latter worked better than sulfasalazine again, and after 11 years, in 2010, another study showed lower mortality rates in patients taking the combination than the sulfasalazine alone.

The new study, which drew upon data from 154 of the original 155 patients, found lower mortality rates among the participants (28 percent) than among the general population (28 percent). “The difference between the two therapeutic approaches was not significant, and the positive trend for combined therapy over sulfasalazine decreased over time,” according to the release.