Risk of diabetes among patients with rheumatoid arthritis, psoriatic arthritis and psoriasis.
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.
Solomon
Daniel H
DH
Division of Rheumatology, Department of Medicine, Boston, MA 02115, USA. dsolomon@partners.org
Love
Thorvardur Jon
TJ
Canning
Claire
C
Schneeweiss
Sebastian
S
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D001955:British Columbia / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology*; D004363:Drug Utilization / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D017678:Sex Distribution
D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents