Disease-modifying anti-rheumatic drugs associated with different diabetes risks in patients with rheumatoid arthritis

Yu Jih Su, Hui Ming Chen, Tien Ming Chan, Tien Tsai Cheng, Shan Fu Yu, Jia Feng Chen, Chun Yu Lin, Chung Yuan Hsu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

2 Scopus citations

Abstract

Objectives Patients with rheumatoid arthritis are prone to developing diabetes, which may lead to various sequelae and even cardiovascular diseases, the most common cause of death in such patients. Previous research has shown that some rheumatoid arthritis treatments may help prevent the development of diabetes. This study aimed to investigate whether patients using disease-modifying anti-rheumatic drugs (DMARDs) may have different levels of risk for diabetes and to analyse other risk factors for diabetes. Methods This cohort study used data from the Chang Gung Research Database. 5530 adults with rheumatoid arthritis but without diabetes were eligible for the analysis. The endpoint of this study was new-onset diabetes, defined as an HbA1c value ≥7% during follow-up. The entire follow-up period was divided into monthly subunits. These 1-month units were then divided into methotrexate (MTX) monotherapy, any biological DMARDs (bDMARDs), MTX combination, other conventional DMARDs (cDMARDs) and non-DMARDs. Results A total of 546 participants (9.87%) developed diabetes between 2001 and 2018. The risk of diabetes was significantly lower in the bDMARD periods (HR 0.51; 95% CI 0.32 to 0.83), MTX combination periods (HR 0.50; 95% CI 0.32 to 0.78) and other cDMARD periods (HR 0.56; 95% CI 0.37 to 0.84) than in the MTX monotherapy periods. Individual drug analysis showed that hydroxychloroquine (HR 0.52; 95% CI 0.42 to 0.65) reduced the risk of diabetes. Tumour necrosis factor-α inhibitors (HR 0.69; 95% CI 0.46 to 1.03) tended to be protective. Conclusion Patients with rheumatoid arthritis may have different levels of risk of diabetes depending on the treatment options.

Original languageEnglish
Article number003045
JournalRMD Open
Volume9
Issue number3
DOIs
StatePublished - 17 07 2023

Bibliographical note

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords

  • Hydroxychloroquine
  • Rheumatoid Arthritis
  • Tumor Necrosis Factor Inhibitors
  • Diabetes Mellitus/drug therapy
  • Arthritis, Rheumatoid/complications
  • Humans
  • Adult
  • Antirheumatic Agents/adverse effects
  • Methotrexate/adverse effects
  • Cohort Studies

Fingerprint

Dive into the research topics of 'Disease-modifying anti-rheumatic drugs associated with different diabetes risks in patients with rheumatoid arthritis'. Together they form a unique fingerprint.

Cite this