| Diabetes risk in rheumatoid arthritis: Reduced incidence with anti-tumor necrosis factor- α therapy. | |
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MedLine Citation:
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PMID: 21972198 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: To examine the association of TNF-α inhibitor use and the risk of developing diabetes in a rheumatoid arthritis (RA) inception cohort. METHODS: Adults diagnosed with RA between 1/1/2001 - 12/31/2009 were identified (n=1881). Prevalent cases of diabetes (n=294) were excluded. Information on sociodemographic data, medical history, body mass index (BMI), laboratory measures and medications was collected from the electronic health record. Incident diabetes was defined using the 2010 American Diabetes Association criteria or physician established diagnosis. Time-varying Cox proportional hazard regression models were used to adjust for age, gender, race, BMI, rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (anti-CCP), erythrocyte sedimentation rate (ESR), and use of non-steroidal anti-inflammatory drugs (NSAID), glucocorticoids, hydroxychloroquine and methotrexate. RESULTS: 1587 non-diabetic incident RA patients were included. The anti-TNF-α users (n=522) had a lower median age but greater baseline BMI, maximum ESR, RF and anti-CCP positivity, and NSAID, glucocorticoid or methotrexate use. The median follow-up time for the ever- and never-TNF-α inhibitor users was 44.9 (23.7-73.0) months and 37.1 (16.3-65.1) months, respectively (p<.001). Of the 91 patients developing diabetes, 16 were ever- and 75 were never-TNF-α inhibitor users, yielding incidence rates of 8.6 and 17.2 per 1000 person-years (p=0.048), respectively. Adjusting for covariates, the hazard ratio for incident diabetes in TNF-α inhibitor users was 0.49 (CI 0.24-0.99, p=0.049) compared to the never-users. CONCLUSION: In this inception RA cohort, anti-TNF-α use was associated with a 51% reduction in risk of developing diabetes. © 2011 by the American College of Rheumatology. |
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Authors:
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Jana L Antohe; Androniki Bili; Jennifer A Sartorius; H Lester Kirchner; Stephanie J Morris; Sorina Dancea; Mary Chester M Wasko |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-10-3 |
Journal Detail:
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Title: Arthritis care & research Volume: - ISSN: 2151-4658 ISO Abbreviation: - Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-5 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101518086 Medline TA: Arthritis Care Res (Hoboken) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 by the American College of Rheumatology. |
Affiliation:
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Department of Rheumatology, Geisinger Medical Center, Danville, PA. |
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