Korean J Clin Pharm.  2019 Jun;29(2):109-114. 10.24304/kjcp.2019.29.2.109.

The Risk of Cardiovascular Disease and Diabetes in Rheumatoid Arthritis Patients: A Propensity Score Analysis

• Rhew K

• KMID: 2452859
• DOI: http://doi.org/10.24304/kjcp.2019.29.2.109

Abstract

BACKGROUND
Rheumatoid arthritis (RA) is a systemic inflammatory disease that manifests as joint damage or athletic disability via sustained inflammation of the synovial membrane. The risk of cardiovascular disease (CVD) is higher in RA patients. This study aimed at evaluating the association between CVD comorbidities and RA by comparing a pharmacotherapy group with a non-pharmacotherapy group.
METHODS
Patient sample data from the Health Insurance Review and Assessment Service (HIRA-NPS-2016) were used. Inverse probability of treatment weighting (IPTW) using the propensity score was used to minimize the differences in patient characteristics. Logistic regression analysis was used to evaluate the risk of CVD comorbidities.
RESULTS
The analyses included 1,207,213 patients, of which 33,122 (2.8%) had RA. The odds ratios (OR) of CVD comorbidities were increased in RA patients; ischemic heart disease (IHD: OR 1.75; 95% CI 1.73, 1.77), cerebral infarction (CERI: OR 1.28; 95% CI 1.26, 1.30), hypertension (HTN: OR 1.44; 95% CI 1.43, 1.45), diabetes mellitus (DM: OR 2.04; 95% CI 2.03, 2.06), and dyslipidemia (DL: OR 3.49; 95% CI 3.47, 3.51). The ORs of IHD, CERI, HTN, and DM in the traditional DMARD and biologic treatment groups were decreased, compared with those in the non-pharmacotherapy group.
CONCLUSIONS
Thus, CVD risk was higher in RA patients, considering age, sex, and socioeconomic status. Appropriate pharmacotherapy could decrease the risk of CVD comorbidities in RA patients.

Keyword

Rheumatoid arthritis; cardiovascular disease; DMARD; biologic agents

MeSH Terms

Antirheumatic Agents
Arthritis, Rheumatoid*
Biological Factors
Cardiovascular Diseases*
Cerebral Infarction
Comorbidity
Diabetes Mellitus
Drug Therapy
Dyslipidemias
Humans
Hypertension
Inflammation
Insurance, Health
Joints
Logistic Models
Myocardial Ischemia
Odds Ratio
Propensity Score*
Social Class
Sports
Synovial Membrane
Antirheumatic Agents
Biological Factors