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DPP-4 Inhibitor-Induced Rheumatoid Arthritis Among Diabetics: A Nested Case–Control Study

INTRODUCTION: The risk of rheumatoid arthritis (RA) associated with dipeptidyl peptidase-4 inhibitor (DPP-4i) use is unclear. This study assesses the RA risk associated with DPP-4i use among a diabetic cohort initiating second-line therapy. METHODS: This was a nested case–control study, using the ad...

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Autores principales: Kathe, Niranjan, Shah, Anuj, Said, Qayyim, Painter, Jacob T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5801239/
https://www.ncbi.nlm.nih.gov/pubmed/29236221
http://dx.doi.org/10.1007/s13300-017-0353-5
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author Kathe, Niranjan
Shah, Anuj
Said, Qayyim
Painter, Jacob T.
author_facet Kathe, Niranjan
Shah, Anuj
Said, Qayyim
Painter, Jacob T.
author_sort Kathe, Niranjan
collection PubMed
description INTRODUCTION: The risk of rheumatoid arthritis (RA) associated with dipeptidyl peptidase-4 inhibitor (DPP-4i) use is unclear. This study assesses the RA risk associated with DPP-4i use among a diabetic cohort initiating second-line therapy. METHODS: This was a nested case–control study, using the adult diabetic population starting second-line antidiabetic therapy from IMS LifeLink Plus(®) database (2006–2015). Cases were those with two or more RA diagnosis, at least one prescription, and 180 days enrollment prior to the event date (earliest of the two: first RA diagnosis, first RA prescription). Controls were drawn from the nest after matching (1:15) with cases on index date (± 90 days), age (± 5 years), sex, and event date (imputed to have the same time difference between cohort entry and event date as the matched case). Exposure and covariate information was gathered from the 180-day period prior to event date. Conditional logistic regression was used to assess exposure among cases and controls. Adjusted analysis was carried out after controlling for important medications and comorbidities. RESULTS: The final sample consists of 790 cases and 11,850 controls; of these, 151 cases (19.11%) and 2177 controls (18.37%) had DPP-4i claims during the exposure assessment period. DPP-4i therapy was not significantly associated with the development of RA after adjusting for covariates (OR = 1.156, 95% CI 0.936–1.429). Changing the exposure definition or exposure window to 1 year and subgroup analyses yielded similar results except for the non-insulin-using subgroup (OR = 1.299, 95% CI 1.001–1.985) which showed a significant positive association. CONCLUSION: DPP-4i were not significantly associated with the risk of RA compared with other second-line antidiabetic therapies.
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spelling pubmed-58012392018-02-12 DPP-4 Inhibitor-Induced Rheumatoid Arthritis Among Diabetics: A Nested Case–Control Study Kathe, Niranjan Shah, Anuj Said, Qayyim Painter, Jacob T. Diabetes Ther Original Research INTRODUCTION: The risk of rheumatoid arthritis (RA) associated with dipeptidyl peptidase-4 inhibitor (DPP-4i) use is unclear. This study assesses the RA risk associated with DPP-4i use among a diabetic cohort initiating second-line therapy. METHODS: This was a nested case–control study, using the adult diabetic population starting second-line antidiabetic therapy from IMS LifeLink Plus(®) database (2006–2015). Cases were those with two or more RA diagnosis, at least one prescription, and 180 days enrollment prior to the event date (earliest of the two: first RA diagnosis, first RA prescription). Controls were drawn from the nest after matching (1:15) with cases on index date (± 90 days), age (± 5 years), sex, and event date (imputed to have the same time difference between cohort entry and event date as the matched case). Exposure and covariate information was gathered from the 180-day period prior to event date. Conditional logistic regression was used to assess exposure among cases and controls. Adjusted analysis was carried out after controlling for important medications and comorbidities. RESULTS: The final sample consists of 790 cases and 11,850 controls; of these, 151 cases (19.11%) and 2177 controls (18.37%) had DPP-4i claims during the exposure assessment period. DPP-4i therapy was not significantly associated with the development of RA after adjusting for covariates (OR = 1.156, 95% CI 0.936–1.429). Changing the exposure definition or exposure window to 1 year and subgroup analyses yielded similar results except for the non-insulin-using subgroup (OR = 1.299, 95% CI 1.001–1.985) which showed a significant positive association. CONCLUSION: DPP-4i were not significantly associated with the risk of RA compared with other second-line antidiabetic therapies. Springer Healthcare 2017-12-13 2018-02 /pmc/articles/PMC5801239/ /pubmed/29236221 http://dx.doi.org/10.1007/s13300-017-0353-5 Text en © The Author(s) 2017 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research
Kathe, Niranjan
Shah, Anuj
Said, Qayyim
Painter, Jacob T.
DPP-4 Inhibitor-Induced Rheumatoid Arthritis Among Diabetics: A Nested Case–Control Study
title DPP-4 Inhibitor-Induced Rheumatoid Arthritis Among Diabetics: A Nested Case–Control Study
title_full DPP-4 Inhibitor-Induced Rheumatoid Arthritis Among Diabetics: A Nested Case–Control Study
title_fullStr DPP-4 Inhibitor-Induced Rheumatoid Arthritis Among Diabetics: A Nested Case–Control Study
title_full_unstemmed DPP-4 Inhibitor-Induced Rheumatoid Arthritis Among Diabetics: A Nested Case–Control Study
title_short DPP-4 Inhibitor-Induced Rheumatoid Arthritis Among Diabetics: A Nested Case–Control Study
title_sort dpp-4 inhibitor-induced rheumatoid arthritis among diabetics: a nested case–control study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5801239/
https://www.ncbi.nlm.nih.gov/pubmed/29236221
http://dx.doi.org/10.1007/s13300-017-0353-5
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