RESEARCH - Risk of diabetes among patients with RA, psoriatic arthritis, and psoriasis

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Ann Rheum Dis doi:10.1136/ard.2009.125476

Basic and translational research

Extended report

Risk of diabetes among patients with rheumatoid arthritis, psoriatic

arthritis and psoriasis

H 1,2, Thorvardur Jon Love1, Canning2, Sebastian

Schneeweiss2

+ Author Affiliations

1Division of Rheumatology, Department of Medicine, Brigham and Women's

Hospital, Boston, Massachusetts, USA

2Division of Pharmacoepidemiology, Department of Medicine, Brigham and

Women's Hospital, Boston, Massachusetts, USA

Abstract

Objective

To examine the risk of diabetes mellitus (DM) among subjects with

rheumatoid arthritis (RA), psoriatic arthritis or psoriasis (PsA/PsO),

compared with non-rheumatic controls.

Methods

Study cohorts were assembled using linked healthcare utilisation data

from British Columbia. All people with at least two diagnoses of RA or

PsA/PsO were included and compared with a cohort of people without any

known rheumatic disease. The outcome of interest was a diagnosis of

new-onset DM, as defined by initiation of an antidiabetic drug.

Incidence rates (IRs) per 1000 person-years and IR ratios were

calculated and regression models were constructed to determine the

hazard ratio (HR) for diabetes by age, gender, systemic

immunosuppressive drug and glucocorticoid use.

Results

The study cohort comprised 48 718 subjects with RA, 40 346 with

PsA/PsO and 442 033 without any rheumatic disease. The IR for DM among

subjects with RA was 8.6 per 1000 person-years (95% CI 8.5 to 8.7),

PsA/PsO 8.2 (95% CI 8.1 to 8.3) and for non-rheumatic controls 5.8

(95% CI 5.8 to 5.8). The adjusted HR for RA compared with

non-rheumatic controls was 1.5 (95% CI 1.4 to 1.5) and 1.4 (95% CI 1.3

to 1.5) for PsA/PsO.

Conclusions

RA and PsA/PsO appear to be associated with an increased risk of DM.

The ability of potent antirheumatic treatments to reverse this trend

warrants study.

http://ard.bmj.com/content/early/2010/06/28/ard.2009.125476.abstract?papetoc

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