Abstract
OBJECTIVE: Rheumatoid arthritis (RA) is the most common form of inflammatory arthritis and primarily affects the joints. While therapeutic advances have substantially reduced the risk of long-term disability, concerns remain regarding disease-related morbidity. Therefore, we aimed to evaluate incidence, prevalence, mortality rates (MRs), standardised mortality ratios (SMRs) and causes of death in RA in north-eastern Italy from 2012 to 2020. METHODS: A retrospective population-based study was conducted in the Veneto region (4.8 million residents) using linked data from the population registry, healthcare co-payment exemptions, hospital discharge records and mortality data. Prevalence and incidence rates were stratified by age and sex. SMRs were calculated by comparing patients with RA to the general population. Causes of death were classified by the International Classification of Diseases Tenth Revision (ICD-10). RESULTS: We identified 37 996 patients with RA (prevalence 0.54%) and 12 875 incident cases (incidence rate 33.1/100 000). Incidence was twice as high in females. Among prevalent cases, 7 435 deaths occurred (MR 32.2/1000), while among incident cases there were 1288 deaths over the 8-year study period (MR 21.3/1000). The median age at death was 83 (77-88) years. The overall SMR was 1.28 (95% CI 1.21 to 1.35), higher in patients under 45 years of age (2.15, 95% CI 0.93 to 4.24). Leading causes of death were cardiovascular diseases (37.1%), cancer (20.6%) and infections (10.9%). CONCLUSIONS: This study provides updated data on epidemiology and mortality of RA in Italy, offering insights for healthcare planning and resource allocation. The analysis of causes of death provides additional perspectives for a multidimensional approach to disease management.