| Abstract [eng] |
Systemic connective tissue diseases (SCTDs) are a group of rare chronic inflammatory diseases, characterized by an autoimmune mechanism that results in damage to multiple organ systems in the human body. Although recent advancements in diagnostic and treatment methods have improved disease prognosis, SCTDs are still associated with higher mortality and shorter life expectancy than in the general population. The mortality risk of these diseases in Lithuania has not been extensively studied, therefore, it is important to determine mortality risk indicators among individuals with SCTDs and assess their characteristics. Aim of the study – to evaluate the mortality risk of patients with systemic connective tissue diseases in Lithuania and worldwide. Objectives: 1. To determine the mortality risk of Lithuanian residents with systemic connective tissue diseases over the period of 2013 – 2017 according to sex and age groups. 2. To assess the impact of prescribed reimbursed medications on the mortality risk of Lithuanian residents with systemic connective tissue diseases over the period of 2013 – 2017. 3. To evaluate the mortality risk of systemic connective tissue diseases worldwide by systematically reviewing results of scientific studies conducted in various countries. Methods: A national retrospective cohort study was conducted using data from the Compulsory Health Insurance Information System “SVEIDRA” on Lithuanian individuals who were newly diagnosed with SCTDs between 2013 and 2017. Standardized mortality ratios (SMRs) were calculated to assess mortality risk. A systematic literature review and meta-analysis were performed to evaluate the mortality risk of individuals with SCTDs worldwide. Results: The study found that the mortality risk of individuals with SCTDs in Lithuania was statistically significantly higher than in the general population. The highest risk was observed in the 18 – 59 age group (SMR ¬= 2.64). Analysis of the impact of medication showed a statistically significantly higher mortality risk in patients who were treated with non-biological disease-modifying antirheumatic drugs (DMARDs) (SMR = 1.38, P < 0.001) compared to the general population. Results of the meta-analysis confirmed that a diagnosis of SCTDs is associated with increased standardized mortality ratios worldwide, including in Lithuania. |
