Common RA Drugs Increase the Risk of Diabetes

Statins and glucocorticoids are associated with an increased risk of diabetes in patients with rheumatoid arthritis (RA), according to a new study.

Previous research has found that glucocorticoids may increase the risk of diabetes in RA patients. For this reason, in the current study, the researchers examined the effect of different disease-modifying antirheumatic drugs (DMARDs) and statin treatments on the risk of diabetes.
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To conduct their study, the researchers identified 13,669 patients with RA and without baseline diabetes who had been participating in the National Data Bank for Rheumatic Diseases for 1 year or more from 2000 to 2014.

Patients taking DMARDs were separated into 4 categories: methotrexate monotherapy, any abatacept with or without synthetic DMARDs, any other DMARDs with methotrexate, and all other DMARDs without methotrexate. Patients taking statins, glucocorticoid, and hydroxychloroquine were also assessed separately.

Diabetes was recorded via self-report or initiation of diabetes medication.

After a median 4.6 years, 1139 patients (8.3%) developed diabetes. The standardized incidence ratio of diabetes in RA patients was 1.37 per 100 person-years compared with the general US population.

Statin therapy increased the risk of diabetes by 56%, and glucocorticoids increased the risk by 31%. However, hydrochloroquine and abatacept were associated with a reduced risk of diabetes.

“In RA, incidence of [diabetes mellitus] is increased,” the researchers concluded. “Hydroxychloroquine and abatacept were associated with decreased risk of [diabetes mellitus], and glucocorticoids and statins with increased risk.”

—Amanda Balbi

Reference:

Ozen G, Pedro S, Holmqvist ME, Avery M, Wolfe F, Michaud K. Risk of diabetes mellitus associated with disease-modifying antirheumatic drugs and statins in rheumatoid arthritis [published online November 11, 2016]. Ann Rheum Dis. doi:10.1136/annrheumdis-2016-209954.