Yao-Min Hung1,2,3, Yu-Hsun Wang4, Lichi Lin5,6, Paul Yung Pou Wang7, Jeng-Yuan Chiou8, James Cheng-Chung Wei6,9. 1. Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. 2. School of Medicine, Institute of Public Health, National Yang Ming University, Taipei, Taiwan. 3. Yuhing Junior College of Health Care and Management, Kaohsiung, Taiwan. 4. Department of Medical Research, Chung Shan Medical University, Taichung, Taiwan. 5. Department of Statistics, Oklahoma state University, Oklahoma, USA. 6. Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan. 7. Division of Nephrology, Kaiser Permanente Baldwin Park Medical Center, Baldwin Park, CA, USA. 8. School of Health Policy and Management, Chung Shan Medical University, Taichung, Taiwan. 9. Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
Abstract
OBJECTIVES: The aim of this study was to determine whether hydroxychloroquine (HCQ) usage is associated with incidental risk of coronary artery diseases (CAD) in patients with rheumatoid arthritis (RA). METHODS: The Longitudinal Health Insurance Database in Taiwan was used. The study cohort comprised of 1104 newly diagnosed RA patients between 2001-2010, and patients were followed until 31 December 2011. Patients with history of CAD before RA diagnosis were excluded. We define as HCQ users if the usage duration of HCQ>180 days and non-users if less than 90 days. After propensity score matching of age, sex, index date and comorbidities, the study cohort was comprised of 346 patients: 173 HCQ users and 173 non-users. The study outcome was incidence of CAD. Cox regression model was used to estimate the hazard ratio (HR) of disease after controlling for demographic, other comorbidities and drugs. We also evaluate the effects of HCQ use and CAD events on different characteristics of RA patients. RESULTS: Kaplan-Meier curves comparing the HCQ users and non-users revealed a statistical significant difference (P value of log-rank test <.001). The adjusted HR for HCQ users versus non-users for CAD events was 0.32 (95% CI, 0.18-0.56, P value <.01) over up to 10 years of follow-up. The adjusted HR (95% CI) of CAD for different age group, gender and other subgroups showed no effect of interaction among each subgroup analysis parameter. CONCLUSIONS: This study revealed association of decreased CAD risk in RA patients taking HCQ. The protective effect of HCQ on CAD is consistent regarding subgroup analysis on age, gender and different comorbidities groups.
OBJECTIVES: The aim of this study was to determine whether hydroxychloroquine (HCQ) usage is associated with incidental risk of coronary artery diseases (CAD) in patients with rheumatoid arthritis (RA). METHODS: The Longitudinal Health Insurance Database in Taiwan was used. The study cohort comprised of 1104 newly diagnosed RApatients between 2001-2010, and patients were followed until 31 December 2011. Patients with history of CAD before RA diagnosis were excluded. We define as HCQ users if the usage duration of HCQ>180 days and non-users if less than 90 days. After propensity score matching of age, sex, index date and comorbidities, the study cohort was comprised of 346 patients: 173 HCQ users and 173 non-users. The study outcome was incidence of CAD. Cox regression model was used to estimate the hazard ratio (HR) of disease after controlling for demographic, other comorbidities and drugs. We also evaluate the effects of HCQ use and CAD events on different characteristics of RApatients. RESULTS: Kaplan-Meier curves comparing the HCQ users and non-users revealed a statistical significant difference (P value of log-rank test <.001). The adjusted HR for HCQ users versus non-users for CAD events was 0.32 (95% CI, 0.18-0.56, P value <.01) over up to 10 years of follow-up. The adjusted HR (95% CI) of CAD for different age group, gender and other subgroups showed no effect of interaction among each subgroup analysis parameter. CONCLUSIONS: This study revealed association of decreased CAD risk in RApatients taking HCQ. The protective effect of HCQ on CAD is consistent regarding subgroup analysis on age, gender and different comorbidities groups.
Authors: April Jorge; Na Lu; Hyon Choi; John M Esdaile; Diane Lacaille; J Antonio Avina-Zubieta Journal: Arthritis Care Res (Hoboken) Date: 2021-12-23 Impact factor: 5.178