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This observational cohort study was performed with an objective to compare the risk of diabetes mellitus (DM) in patients suffering from rheumatoid arthritis (RA) who were treated with biologic or targeted synthetic disease‐modifying antirheumatic drugs.
For comparative risk of DM among patients with RA, the data
from 2 nationwide data sources in the United States, stated that abatacept is
linked with a lower risk of incident DM, than with TNF‐inhibitors, in patients
with RA. Comparison of abatacept with other agents was unconvincing due to
reduced event counts presented for valid treatment‐effect estimation.
This observational cohort
study was performed with an objective to compare the risk of diabetes mellitus
(DM) in patients suffering from rheumatoid arthritis (RA) who were treated with
biologic or targeted synthetic disease‐modifying antirheumatic drugs.
The data was obtained from
a US commercial (Truven MarketScan, 2005‐2016) and public
insurance (Medicare, 2010‐2014) claims databases. The RA
patients who did not have DM were designated into 1 out of 8
exposure groups (namely, adalimumab, abatacept, certolizumab, etanercept, golimumab,
infliximab, tocilizumab, or tofacitinib). The combination of a diagnosis code
and beginning of a hypo-glycemic treatment helped to examine the outcome of
incident DM. Stabilized inverse probability–weighted Cox proportional
hazards model accounted for 56 confounding variables and estimated hazard
ratios (HRs) and 95% confidence intervals (CIs). All the analyses were managed separately
in 2 databases, and estimates were combined via the inverse variance meta‐analysis.
Amongst the 50,505 RA patients from
Truven and 17,251 RA patients from Medicare, the rate of incidence (95% CI)
for DM were 6.8 (6.1‐7.6) and 6.6 (5.4‐7.9)
per 1000 person‐years. The pooled HRs (95% CI) specified a considerably
higher risk of DM among adalimumab (2.00 [1.11‐3.03]) and
infliximab initiators (2.34 [1.38‐3.98]) than abatacept. Pooled HR
for the etanercept against abatacept was higher but not statistically
significant (1.65 [0.91‐2.98]). Due to small sample size,
the effect estimates for certolizumab, golimumab, tocilizumab, and tofacitinib
were inaccurate than with abatacept.
Using abatacept was linked
with a lower risk of incident DM in RA patients than with
adalimumab or infliximab initation.
ACR Open Rheumatology
Comparative Risk of Diabetes Mellitus in Patients with Rheumatoid Arthritis Treated With Biologic or Targeted Synthetic Disease‐Modifying Drugs: A Cohort Study
Rishi J. Desai et al.
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