- Patients with rheumatoid arthritis (RA) were at a substantially increased incidence of glucocorticoid (GC)-related adverse events (AEs).
- Increasing cumulative and average daily GC doses were associated with a greater risk of developing an AE.
Why this matters
- Findings highlight the clinical burden associated with current and long-term, high-dose oral GC use in patients with RA and emphasize the importance of clinical awareness of GC-related AEs.
- This study included 34,050 patients with RA and 1:1 matched patients without RA using data from the UK Clinical Practice Research Datalink (CPRD).
- Funding: F. Hoffmann-La Roche and Genentech, Inc.
- RA patients with a GC prescription vs. non-RA patients with a GC prescription had a higher incidence of severe AEs:
- diabetes (incidence rate ratio [IRR], 1.33; 95% CI, 1.12-1.56);
- osteoporosis (IRR, 2.30; 95% CI, 2.00-2.65);
- fractures (IRR, 1.34; 95% CI, 1.17-1.54);
- hypertension (IRR, 1.40; 95% CI, 1.26-1.57);
- thrombotic stroke or myocardial infarction (MI; IRRs, 1.45; 95% CI, 1.19-1.76);
- gastrointestinal perforation or bleeding (IRR, 1.59; 95% CI, 1.21-2.08);
- mortality (IRR, 1.26; 95% CI, 1.16-1.37); and
- serious infection (IRR, 1.24; 95% CI, 1.06-1.44).
- In patients with RA, GC use was associated with an increased risk of:
- diabetes (adjusted OR [aOR], 1.33; 95% CI, 1.14-1.56);
- osteoporosis (aOR, 1.41; 95% CI, 1.25-1.59);
- thrombotic stroke or MI (aOR, 1.28; 95% CI, 1.07-1.52);
- serious infection (aOR, 1.28; 95% CI, 1.11-1.48); and
- mortality (aOR, 1.33; 95% CI, 1.19-1.48).
- Both increasing cumulative and average daily GC doses (Ptrend<.05 for both were associated with increased risks of diabetes osteoporosis fractures infections thrombotic stroke or mi and mortality.>
- Possibility of competing risks.