Association of Cardiovascular Outcomes With Low‐Dose Glucocorticoid Prescription in Patients With Rheumatoid Arthritis
Authors' conclusion
Among older patients with more comorbidities and younger patients with higher cardiovascular risk with RA on stable DMARD therapy, glucocorticoids were associated with a dose-dependent increased risk of MI and stroke, even at doses ≤5 mg/day. By contrast, no association was noted among younger, healthier patients with RA.
Study context
- Population
- Patients with rheumatoid arthritis (RA) on stable DMARD therapy for >180 days, Medicare and Optum Clinformatics Data Mart (CDM) claims databases135,583 Medicare
- Exposure
- Glucocorticoid dose categories vs no glucocorticoids
- Outcome
- Composite cardiovascular outcomes (stroke or MI)
Methodological detailstwo claims databases, inverse-probability weighted proportional hazards models, clustering for multiple observations
- Two claims databases
- Inverse-probability weighted proportional hazards models
- Clustering for multiple observations
Main finding
As reported in the abstract
Predicted one-year incidence of composite CV outcomes, Medicare cohort (adjusted)
Observational data: associations, not effects.
Further findings
Incidence of composite CV outcomes per 100 person-years
- Medicare
- 1.3
- CDM
- 0.8
Composite CV outcomes, CDM cohort
- No significant association
Composite CV outcomes, CDM younger patients with higher CV risk (subgroup)
- Dose-dependent increase with GC
Original publication
Association of Cardiovascular Outcomes With Low‐Dose Glucocorticoid Prescription in Patients With Rheumatoid Arthritis. Arthritis Rheumatol. Published 23 July 2024. doi:10.
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