Hydroxychloroquine Use and Decreased Risk of Diabetes in Rheumatoid Arthritis Patients

JCR: Journal of Clinical Rheumatology, 04/06/2011

Bili A et al. - The findings support the potential benefit of hydroxychloroquine in attenuating the risk of diabetes in rheumatoid arthritis patients..


  • Retrospective cohort of 1127 adults with newly diagnosed rheumatoid arthritis and no diabetes within the Geisinger Health System between January 1, 2003, and March 31, 2008.
  • Patients were classified as ever users (n = 333) or never users (n = 794) of hydroxychloroquine.
  • Incident diabetes cases were defined using 2010 American Diabetes Association criteria.


  • The median follow-up times for the ever and never hydroxychloroquine users were 26.0 and 23.0 months, respectively (P = 0.28).
  • The median duration of hydroxychloroquine exposure was 14.0 months.
  • Of the 48 cases developing diabetes during observation, 3 were exposed to hydroxychloroquine at time of development and 45 were nonexposed, yielding incidence rates of 6.2 and 22.0 per 1000 per year (P = 0.03), respectively.
  • In time-varying Cox proportional hazards regression models adjusting for sex, age, body mass index, positive rheumatoid factor and anti-cyclic citrullinated peptide antibodies, erythrocyte sedimentation rate, and nonsteroidal anti-inflammatory drug, glucocorticoid, methotrexate, and tumor necrosis factor (alpha) inhibitor use, the hazard ratio for incident diabetes among hydroxychloroquine users was 0.29 (95% confidence interval, 0.09-0.95; P = 0.04) compared with nonusers.

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