Time and dose-dependent effect of systemic glucocorticoids on major adverse cardiovascular event in patients with rheumatoid arthritis: a population-based study
Authors' conclusion
GC was associated with a duration and dose-dependent increased risk of MACE in patients with RA. Very low dose prednisolone (<5 mg daily) did not appear to confer excessive CV risk.
Study context
- Population
- Patients with rheumatoid arthritis (RA) without major adverse cardiovascular events (MACE) at baseline, Hong Kong citywide database, 2006 to 2015, followed till 2018
- Participants
- 12,233 patients105,826 patient-years
- Exposure
- Daily prednisolone ≥5 mg or <5 mg vs no glucocorticoids (GC) use
- Outcome
- First occurrence of an MACE
Methodological detailsCox regression and inverse probability treatment weighting, time-varying covariates, Hong Kong citywide database
- Cox regression and inverse probability treatment weighting
- Time-varying covariates
- Hong Kong citywide database
Main finding
As reported in the abstract
MACE
Prednisolone ≥5 mg vs No GCHazard ratio (95% CI)
ESR model; time-varying, adjusted
2.02(1.72–2.37)
CRP model; time-varying, adjusted
1.87(1.60–2.18)
- In daily prednisolone ≥5 mg, risk of incident MACE increased per month
- 7%
Observational data: associations, not effects.
Original publication
Time and dose-dependent effect of systemic glucocorticoids on major adverse cardiovascular event in patients with rheumatoid arthritis: a population-based study. Ann Rheum Dis. Published 24 July 2023. doi:10.
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