Risk of diabetes among patients with rheumatoid arthritis, psoriatic arthritis and psoriasis

• Published in: Annals of the rheumatic diseases Vol. 69; no. 12; pp. 2114 - 2117
• Main Authors: Solomon, Daniel H, Love, Thorvardur Jon, Canning, Claire, Schneeweiss, Sebastian
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.12.2010; BMJ Publishing Group; Elsevier Limited
• Subjects: Adult; Age Distribution; Aged; Aged, 80 and over; Antirheumatic Agents - therapeutic use; Arthritis, Psoriatic - complications; Arthritis, Psoriatic - drug therapy; Arthritis, Psoriatic - epidemiology; Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - epidemiology; Biological and medical sciences; Breath tests; British Columbia - epidemiology; Comorbidity; Dermatology; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - etiology; Diabetes. Impaired glucose tolerance; Diseases of the osteoarticular system; Drug Utilization - statistics & numerical data; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Epidemiologic Methods; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Humans; Immunosuppressive Agents - therapeutic use; Inflammatory joint diseases; Insulin resistance; Male; Medical sciences; Middle Aged; Prescription drugs; Psoriasis - complications; Psoriasis - drug therapy; Psoriasis - epidemiology; Psoriasis. Parapsoriasis. Lichen; Sex Distribution; British Columbia; Canada; Endocrinopathy; Human; Immunopathology; Skin disease; Psoriasis; Diabetes mellitus; Diseases of the osteoarticular system; Rheumatology; Autoimmune disease; Inflammatory joint disease; Psoriatic arthritis; Spondylarthropathy; Chronic; Rheumatoid arthritis; Risk factor
• ISSN: 0003-4967; 1468-2060; 1468-2060
• DOI: 10.1136/ard.2009.125476

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 Cox 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.