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Antirheumatic Drugs Linked to Lower Diabetes Risk

Risk of diabetes lower for patients with RA or psoriasis treated with biologic agents

TUESDAY, June 21 (HealthDay News) -- Treatment of rheumatoid arthritis (RA) or psoriasis with biologic disease-modifying antirheumatic drugs (DMARDs), such as tumor necrosis factor (TNF) inhibitors, methotrexate, and hydroxychloroquine, may reduce the risk of newly recorded diabetes mellitus (DM), according to a study published in the June 22/29 issue of the Journal of the American Medical Association.

Daniel H. Solomon, M.D., M.P.H., from Brigham and Women's Hospital in Boston, and colleagues investigated whether DMARDs reduced the risk of developing DM in 13,905 patients with either RA or psoriasis, and compared the risk between different DMARDs. Participants received 22,493 DMARD treatment episodes between 1996 and 2008 in one of four regimens: TNF inhibitors with or without other DMARDs; methotrexate; hydroxychloroquine; or other nonbiologic DMARDs. After the first DMARD prescription, the participants were followed up for an average of 5.8 months. Newly diagnosed DM as evidenced by use of a DM-specific medication was the main outcome measure.

The investigators found that the newly recorded DM cases and incidence rates per 1,000 person-years were 55 among 3,993 treatment episodes of other nonbiologic DMARDs (rate, 50.2); 80 among 4,623 treatment episodes of TNF inhibitors (rate, 19.7); 82 among 8,195 treatment episodes of methotrexate (rate, 23.8); and 50 among 5,682 treatment episodes of hydroxychloroquine (rate, 22.2). Compared with other nonbiologic DMARDs, TNF inhibitors, methotrexate, and hydroxychloroquine had multivariate adjusted hazard ratios of 0.62, 0.77, and 0.54, respectively, for DM.

"Among patients with RA or psoriasis, the adjusted risk of DM was lower for individuals starting a TNF inhibitor or hydroxychloroquine compared with initiation of other nonbiologic DMARDs," the authors write.

Several authors disclosed financial relationships with the pharmaceutical and health care industries. The study was funded by Amgen.

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