Table 5.
Multivariable analysis of factors associated with DM with stratification by type of disease
| Variable | AS (n=36,187)
|
RA (n=30,527)
|
PS/PSA (n=15,468)
|
|||
|---|---|---|---|---|---|---|
| Adjusted HR (95% CI) | P-value | Adjusted HR (95% CI) | P-value | Adjusted HR (95% CI) | P-value | |
| Age | 1.06 (1.05, 1.06) | <0.001* | 1.03 (1.03, 1.03) | <0.001* | 1.03 (1.02, 1.03) | <0.001* |
| Sex (male to female) | 1.33 (1.07, 1.64) | 0.009* | 1.04 (0.91, 1.19) | 0.581 | 0.99 (0.84, 1.17) | 0.911 |
| Disease duration | ||||||
| ≤5 years | Reference | Reference | Reference | |||
| >5–10 years | 0.76 (0.49, 1.20) | 0.243 | 0.87 (0.68, 1.11) | 0.266 | 0.78 (0.65, 0.94) | 0.008* |
| >10 years | 1.68 (0.72, 3.94) | 0.228 | 0.66 (0.32, 1.35) | 0.257 | 0.33 (0.22, 0.50) | <0.001* |
| Pretreatment CCI | ||||||
| 0 | Reference | Reference | Reference | |||
| 1 | 1.05 (0.83, 1.33) | 0.682 | 0.92 (0.80, 1.06) | 0.262 | 1.10 (0.88, 1.37) | 0.398 |
| 2–4 | 1.60 (1.21, 2.11) | <0.001* | 1.13 (0.96, 1.32) | 0.144 | 1.16 (0.90, 1.49) | 0.265 |
| ≥5 | 1.48 (0.88, 2.51) | 0.141 | 1.19 (0.87, 1.64) | 0.280 | 1.30 (0.82, 2.06) | 0.260 |
| Pretreatment prednisolone dose a | ||||||
| None | Reference | Reference | Reference | |||
| ≤1 mg/day | 1.35 (1.11, 1.64) | 0.003* | 1.44 (1.25, 1.66) | <0.001* | 1.26 (1.05, 1.51) | 0.012* |
| >1 mg/day | 1.31 (0.99, 1.73) | 0.062 | 1.57 (1.31, 1.90) | <0.001* | 1.50 (1.15, 1.95) | 0.003* |
| DMARD group | Reference | Reference | Reference | |||
| Anti-TNF (CSA/HCQ: −/−) | 0.95 (0.44, 2.04) | 0.897 | 0.90 (0.62, 1.32) | 0.592 | 1.39 (0.66, 2.93) | 0.379 |
| Anti-TNF (CSA/HCQ: +/−) | NA | 0.83 (0.36, 1.92) | 0.666 | NA | ||
| Anti-TNF (CSA/HCQ: −/+) | NA | 0.39 (0.27, 0.58) | <0.001* | 0.44 (0.06, 3.16) | 0.412 | |
| Anti-TNF (CSA/HCQ: +/+) | NA | 0.58 (0.31, 1.08) | 0.086 | NA | ||
| CSA | 1.11 (0.40, 3.06) | 0.844 | 0.92 (0.60, 1.43) | 0.719 | 0.81 (0.66, 1.01) | 0.059 |
| HCQ | 0.54 (0.39, 0.75) | <0.001* | 0.51 (0.43, 0.61) | <0.001* | 0.43 (0.32, 0.59) | <0.001* |
| Prednisolone | 0.70 (0.58, 0.84) | <0.001* | 0.62 (0.51, 0.75) | <0.001* | 0.64 (0.54, 0.77) | <0.001* |
| MTX | 0.83 (0.66, 1.05) | 0.127 | 0.59 (0.52, 0.67) | <0.001* | 0.35 (0.28, 0.43) | <0.001* |
| SSZ | 0.35 (0.25, 0.47) | <0.001* | 0.69 (0.61, 0.78) | <0.001* | 0.63 (0.53, 0.76) | <0.001* |
| LEF | 1.53 (0.72, 3.25) | 0.273 | 0.59 (0.48, 0.73) | <0.001* | 0.58 (0.39, 0.88) | 0.010* |
| AZA | 1.04 (0.64, 1.68) | 0.877 | 1.05 (0.83, 1.33) | 0.677 | 0.60 (0.42, 0.87) | 0.007* |
Notes: Reference for DMARD group: other nonbiologic DMARDs without TNF inhibitors, CSA, or HCQ. NA indicates HR not available due to no new cases of DM.
Daily average-equivalent dose within 1 year before the index date.
Significant association with DM.
Abbreviations: DM, diabetes mellitus; AS, ankylosing spondylitis; RA, rheumatoid arthritis; PS/PSA, psoriasis/psoriatic arthritis; HR, hazard ratio; CI, confidence interval; CCI, Charlson comorbidity index; DMARD, disease-modifying antirheumatic drug; TNF, tumor necrosis factor; CSA, cyclosporine; HCQ, hydroxychloroquine; NA, not available; MTX, methotrexate; SSZ, sulfasalazine; LEF, leflunomide; AZA, azathioprine.