Table 3.
Risk of diabetes treatment intensification and switching in study cohort initiating DMARD therapy
| Event | Patients (n) | Events (n) | Person-years (n) | Incidence rate (95% CI) | HR1 (95% CI) | HR2 (95% CI) |
|---|---|---|---|---|---|---|
| All intensification events (insulin and non-insulin) | ||||||
| Abatacept | 1785 | 248 | 1264.3 | 196.2 (173.2, 222.2) | 1.0 (reference) | 1.0 (reference) |
| TNF inhibitors | 5953 | 875 | 4719.0 | 185.4 (173.5, 198.1) | 0.99 (0.86, 1.14) | 0.97 (0.82, 1.15) |
| Rituximab | 888 | 124 | 626.4 | 198.0 (166.0, 236.1) | 1.00 (0.81, 1.24) | 0.99 (0.79, 1.23) |
| Tocilizumab | 759 | 94 | 514.6 | 182.7 (149.2, 223.6) | 0.93 (0.73, 1.18) | 0.94 (0.74, 1.19) |
| Tofacitinib | 634 | 58 | 391.4 | 148.2 (114.6, 191.7) | 0.72 (0.54, 0.96) | 0.67 (0.50, 0.90) |
| Insulin intensification | ||||||
| Abatacept | 1785 | 102 | 1356.6 | 75.2 (61.9, 91.3) | 1.0 (reference) | 1.0 (reference) |
| TNF inhibitors | 5953 | 320 | 5152.9 | 62.1 (55.7, 69.3) | 0.86 (0.69, 1.07) | 0.87 (0.67, 1.14) |
| Rituximab | 888 | 50 | 673.2 | 74.3 (56.3, 98.0) | 0.98 (0.70, 1.37) | 0.90 (0.64, 1.27) |
| Tocilizumab | 759 | 45 | 540.6 | 83.2 (62.2, 111.5) | 1.10 (0.77, 1.56) | 1.14 (0.80, 1.64) |
| Tofacitinib | 634 | 25 | 410.3 | 60.9 (41.2, 90.2) | 0.78 (0.50, 1.20) | 0.83 (0.52, 1.30) |
| Non-insulin intensification | ||||||
| Abatacept | 1785 | 146 | 1326.6 | 110.1 (93.6, 129.4) | 1.0 (reference) | 1.0 (reference) |
| TNF inhibitors | 5953 | 558 | 4936.4 | 113.0 (104.0, 122.8) | 1.08 (0.90, 1.30) | 1.05 (0.84, 1.31) |
| Rituximab | 888 | 75 | 656.4 | 114.3 (91.1, 143.3) | 1.03 (0.78, 1.36) | 1.06 (0.80, 1.41) |
| Tocilizumab | 759 | 50 | 540.1 | 92.6 (70.2, 122.2) | 0.84 (0.61, 1.16) | 0.83 (0.60, 1.15) |
| Tofacitinib | 634 | 33 | 401.1 | 82.3 (58.5, 115.7) | 0.70 (0.48, 1.02) | 0.59 (0.40, 0.87) |
| Non-insulin switching | ||||||
| Abatacept | 1,503 | 84 | 1157.7 | 72.6 (58.6, 89.9) | 1.0 (reference) | 1.0 (reference) |
| TNF inhibitors | 5050 | 320 | 4387.9 | 72.9 (65.4, 81.4) | 1.04 (0.82, 1.33) | 1.02 (0.77, 1.34) |
| Rituximab | 701 | 48 | 526.8 | 91.1 (68.7, 120.9) | 1.22 (0.85, 1.73) | 1.20 (0.84, 1.72) |
| Tocilizumab | 625 | 35 | 445.3 | 78.6 (56.4, 109.5) | 1.08 (0.73, 1.60) | 1.05 (0.70, 1.58) |
| Tofacitinib | 536 | 26 | 345.7 | 75.2 (51.2, 110.5) | 0.99 (0.64, 1.54) | 1.04 (0.66, 1.64) |
Incidence rate is per 1000 person-years. HR1: hazard ratio 1, unadjusted Cox model. HR2: hazard ratio 2, Cox model adjusted for age, sex, index year, CS use, renal failure, liver disease, number of previous biologic DMARDs, MTX use, HCQ use, statin use, number of oral antidiabetic drugs, number of insulin drugs, number of rheumatologist visits, number of primary care physician visits, number of endocrinologist visits, Charlson co-morbidity score and type 1 diabetes at baseline.