Oral glucocorticoid use increases risk of diabetes in patients with rheumatoid arthritis

Glucocorticoid therapy in patients with rheumatoid arthritis has been linked to elevated risk of diabetes.
Glucocorticoid therapy in patients with rheumatoid arthritis has been linked to elevated risk of diabetes.

Use of glucocorticoids (GC) in patients with rheumatoid arthritis (RA) is a quantifiable risk factor for incident diabetes mellitus (DM), according to research published in Arthritis & Rheumatology.

Mohammad Movahedi, MD, PhD, of the Manchester Academic Health Science Center and the University of Manchester in the UK, and colleagues, conducted a cohort study incorporating the UK Clinical Practice Research Datalink (CPRD) and the US National Data Bank for Rheumatic Diseases (NDB), including 21,962 and 12,657 patients, respectively. The researchers extracted information on the dosage and timing of glucocorticoids in each case.

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In the CPRD, 45% (9,896) of patients received at least 1 prescription for an oral GC; in the NDB, 47% (5,999) patients were treated with oral GCs. During a median follow-up of 5.4 years, 10% (2,260) of patients in the CPRD were diagnosed with new-onset DM, with 57% of the cases being identified through abnormal blood test results. Among patients in the NBD, 6.8% (861) of patients were diagnosed with DM during a median follow-up of 3.4 years.

“A range of conventional statistical models consistently confirmed increases in risk with GC dosage and duration,” said Dr Movahedi. “The weighted cumulative dose model showed that recent GC use contributed the most to the current risk of DM, while doses taken >6 months previously did not influence current risk.”

“GC use is a clinically important and quantifiable risk factor for DM. Risk is influenced by the dosage and treatment duration, although only for GC use within the last 6 months,” Dr Movahedi concluded.

Reference

  1. Movahedi M, Beauchamp M-E, Abrahamowicz M, et al. Risk of incident diabetes mellitus associated with the dosage and duration of oral glucocorticoid therapy in patients with rheumatoid arthritis. Arthritis Rheumatol. 2016;68(5):1089-1098; doi: 10.1002/art.39537
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