Kathe N, et al. - This research encompassed the contemplation of rheumatoid arthritis (RA) associated with dipeptidyl peptidase-4 inhibitor (DPP-4i) use among a diabetic cohort initiating second-line therapy. No prominent link was brought to light between DPP-4i with the risk of RA compared with other second-line antidiabetic therapies.

Methods

• The scheme of this research was a nested case-control study.
• The eligible candidates included adult diabetic population starting second-line antidiabetic therapy from IMS LifeLink Plus database (2006-2015).
• The selected cases were those with two or more RA diagnosis, at least one prescription, and 180 days enrollment prior to the event date (earliest of the two: First RA diagnosis, first RA prescription).
• Controls were enrolled from the nest after matching (1:15) with cases on index date (± 90 days), age (± 5 years), sex, and event date (imputed to have the same time difference between cohort entry and event date as the matched case).
• Exposure and covariate information were obtained from the 180-day period prior to event date.
• In order to gauge the exposure among cases and controls, researchers used the conditional logistic regression.
• After controlling for important medications and comorbidities, an adjusted analysis was performed.

Results

• A total of 790 cases and 11,850 controls were selected.
• Among these, 151 cases (19.11%) and 2177 controls (18.37%) had DPP-4i claims during the exposure assessment period.
• No prominent link was determined between DPP-4i therapy with the development of RA after adjusting for covariates (OR = 1.156, 95% CI 0.936-1.429).
• Similar results were displayed upon changing the exposure definition or exposure window to 1 year and subgroup analyses, with the exception of non-insulin-using subgroup (OR = 1.299, 95% CI 1.001–1.985) that exhibited a marked positive correlation.