Risk of diabetes mellitus associated with disease-modifying antirheumatic drugs and statins in rheumatoid arthritis

Abstract

In RA, incidence of DM is increased. Hydroxychloroquine and abatacept were associated with decreased risk of DM, and glucocorticoids and statins with increased risk.

Response to: ‘Statin therapy now more common than steroids in clinical practice’ by Pareek and Chankurdar

“…This therapeutic advantage of HCQ was also demonstrated in our study2 (see table 1) as shown by Pareek et al 9 for statins, despite the differences in patient characteristics, statin and HCQ doses and durations. This is an important point since both statins and GCs play essential roles in RA and cardiovascular risk management and cannot be avoided because of DM risk.…”

“…We appreciate the interest shown by Pareek and Chankurdar1 concerning our recent study on diabetes mellitus (DM) risk associated with disease-modifying antirheumatic drugs and statins in patients with rheumatoid arthritis (RA) 2. They pointed out that statin-associated DM risk in patients with RA might be a more important concern than the risk attributed to glucocorticoids (GCs) due to longer treatment durations 1…”

“…Concomitant HCQ use might be considered in patients with RA who are on these medications and at high risk for DM. However, for DM risk reduction with HCQ in RA, longer treatment durations may be required (∼2 years+) than in those without inflammatory diseases 2 10–12…”

Metabolic and cardiovascular benefits of hydroxychloroquine: exploration in a wider population at high CV risk

“…Thus, incidence of new-onset diabetes was least with HCQ. In another recent study published in this journal,3 data of 13 669 patients with RA from a longitudinal observational cohort were assessed. The adjusted HRs (95% CI) for diabetes mellitus (DM) were 0.67 (0.57 to 0.80) for HCQ, 1.31 (1.15 to 1.49) for glucocorticoids and 1.56 (1.36 to 1.78) for statins.…”

Statin therapy now more common than steroids in clinical practice

“…In the recent article from Ozen et al 1, the authors found increased risk of diabetes mellitus (DM) in patients with rheumatoid arthritis (RA) compared with normal US adult population.…”