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All participants fulfilled standard classification criteria for rheumatoid arthritis at enrollment,For the purposes of this study, the earliest observation time (study entry) was January 1983 when data were first collected on diabetes.  et al. Peters A, Von KS, Berglind N. Ocular toxicity and hydroxychloroquine: guidelines for screening. PLAQUENIL (hydroxychloroquine sulfate tablets) belongs to the 4-aminoquinoline class. All data, while collected prospectively, were obtained by self-report with the limitations inherent in this approach. et al. The remaining 773 patients (43%) in the ever-use group started taking hydroxychloroquine during the observation period (ie, after study entry). Characteristics of the rheumatoid arthritis patients were grouped according to hydroxychloroquine exposure status (never use and ever use) and are presented in On average, hydroxychloroquine dosing was 340 mg/d over the course of follow-up; 64% of patients took 400 mg/d. Powrie JK, Smith GD, Shojaee-Moradie F, Sonksen PH, Jones RH. Comparison of different methods in analyzing short-term air pollution effects in a cohort study of susceptible individuals.  et al. Gerstein HC, Thorpe KE, Taylor DW, Haynes RB.  et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. The use of this unique longitudinal database with prospectively collected data also allowed for detailed adjustment of covariables that may affect diabetes risk. For both regression analyses, missing values of independent variables were replaced with group means.Statistical analyses were conducted using SAS version 9.1 (SAS Institute Inc, Cary, North Carolina).Prevalent cases of diabetes (n = 211) who were excluded from the analysis were more likely than the included patients to be male, older at entry, nonwhite, less educated, have a higher entry HAQ-DI score, and higher maximum BMI during the observation period (Of the remaining 4905 patients included in the study, 1808 (37%) reported hydroxychloroquine use at some time during the observation period. However, the anti-inflammatory effects of rheumatoid arthritis medications may attenuate both type 1 and type 2 diabetes onset, given the autoimmune nature of type 1 diabetes and the role of chronic inflammation in insulin resistance that characterizes type 2 diabetes.  et al. Emami J, Gerstein HC, Pasutto FM, Jamali F. Insulin-sparing effect of hydroxychloroquine in diabetic rats is concentration dependent. To address this issue, Kaplan-Meier curves based on duration of hydroxychloroquine use were compared with patients with never use over the same observation times. Kanaya AM, Herrington D, Vittinghoff E. Incident Diabetes Rates and Hydroxychloroquine Ever Use vs Never Use Comorbidity in arthritis. Those with never use of hydroxychloroquine were older, had longer rheumatoid arthritis disease duration, were more disabled as indicated by their HAQ scores, and thus may have been considered less viable candidates for immunosuppressive therapy than those with hydroxychloroquine ever use, as suggested by the lower rates of use of prednisone and methotrexate in this group.Differences between groups in year of study entry are consistent with these findings because those with never use were observed earlier when less aggressive treatment strategies were used, and fewer treatment options were available. Bosch J, Yusuf S, Gerstein HC. This reduction in diabetes risk persisted after adjusting for diabetes risk factors and other covariates such as BMI, functional status, and corticosteroid use. Measurement of patient outcome in arthritis.  et al. Type 2 diabetes mellitus affects nearly 8% of US adults, and its prevalence has been increasing.Antimalarials such as hydroxychloroquine, a long-standing safe and inexpensive treatment for autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus, theoretically may improve glucose tolerance and prevent diabetes mellitus. While the disease-modifying properties are not as dramatic as other current treatment options for rheumatoid arthritis, the toxicity profile of hydroxychloroquine is superior to other traditional disease-modifying antirheumatic drugs and biological therapies, leading to its use in mild to moderate disease and in combination therapy for rheumatoid arthritis.The mechanisms of hypoglycemia with hydroxychloroquine are inferred from studies of chloroquine, a structurally similar antimalarial with similar indications but less widespread use due to a greater risk of retinal toxicity. sign up for alerts, and moreto download free article PDFs, Booth GL, Kapral MK, Fung K, Tu JV. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. In contrast to the time-varying regression model, the observation time in the Poisson analysis for patients with hydroxychloroquine ever use began at initiation of hydroxychloroquine.  et al. Chiasson JL, Josse RG, Gomis R.

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