AIM: Disease-modifying antirheumatic drugs (DMARDs) are used in the treatment of most rheumatological diseases (1). There is a number of studies availabile in the literature, in which the effect of DMARDs on mortality has been investigated; however these studies were generally performed on rheumatoid arthritis (RA), and on tumor necrosis factor inhibitors (TNFi) in particular (2-5). Hence, we aimed to conduct a more comprehensive study investigating the effects of using abatacept, adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, rituximab, secukinumab, tofacitinib and tocilizumab on mortality in patients with RA, ankylosing spondylitis (AS), psoriatic arthritis (PsA), Behçet's disease, systemic lupus erythematosus (SLE), Takayasu's arteritis, systemic sclerosis (SSc), Sjogren's syndrome and other rheumatological diseases.MATERIAL AND METHOD: 847 patients that have used bDMARDs were included in our study. Age, gender, diagnosis and treatment information of these patients were retrospectively scanned and recorded. Death records were obtained from the National Death Notification Service (6), whereas the population records were obtained from the Turkish Statistical Institute (7). bDMARD-related incidence rates (IRs) for mortality was calculated.RESULTS: A total of 847 patients, 464 (54.8%) of whom were female and 383 (45.2%) of whom were male, were included in the study. Mortality occurred in a total of 18 patients (2.1%) during the treatment process. Of these 18 patients, 5 patients were using rituximab, 4 patients were using infliximab, 3 patients were using adalimumab, 3 patients were using etanercept, 2 patients were using tocilizumab, and 1 patient were using golimumab. In terms of the mortalities by the type of diagnosis, 13 mortalities occurred in the group of patients diagnosed with RA, whereas 1 mortality occurred in each of the groups consisting of patients diagnosed with AS, PsA, Takayasu arteritis, granulomatosis with polyangiitis (Wegener) or SSc. The overall mortality incidence of the patients was calculated as 5.28 cases per 1000 years. Compared to the general population, the standardized mortality ratio (SMR) of the patients using bDMARDs was found to be 3.147 ((confidence interval (CI): 1.924-4.877)).CONCLUSIONS: Our study is the first mortality study conducted in Turkey on patients with rheumatologic disease that use bDMARDs. The incidence rate (IR) for mortality we have found in patients using bDMARDs was comparable to the IRs reported in the literature, however we have found a higher standart mortalie ratio (SMR) in our cohort compared to the Turkish population. In this respect, it is necessary to conduct larger-scale controlled studies.