Mortality rates and life expectancy in rheumatoid arthritis (RA) influence specific decisions as diverse as an insurance company determining the insurability and annual premiums for an individual seeking to purchase life insurance, and the selection of a drug for treatment of the disease by a physician. Both are important actions, but the facts on which they are based are unclear and our knowledge imprecise and incomplete.
On the basis of personal inquiries of life insurance companies (both large and small) in the United States, a common source of data used by actuaries was identified (1). The study, published in 1970, was based on 475 patients with probable, definite, or classic rheumatoid arthritis who were entered on the Queen's University Rheumatic Diseases Registry in Ontario, Canada between 1954 and 1956. Approximately twothirds of the patients had required hospital care during the period. A modest reduction in life expectancy that was more pronounced in men was found. These findings were consistent with earlier reports by Duthie in 1964 ( 2), Reah in 1963 (3), and Cobb in 1953 (4) and form the basis on which decisions concerning individual applicants are presumably made. Since the report by Uddin et al (I), additional studies on mortality and rheumatoid arthritis have From the Division of