Adherence to Antimalarial Therapy and Risk of Type 2 Diabetes Mellitus Among Patients With Systemic Lupus Erythematosus: A Population‐Based Study. Issue 5 (11th May 2021)

• Record Type: Journal Article
• Authors: Salmasi, Shahrzad; Sayre, Eric C.; Antonio Aviña‐Zubieta, J.; Esdaile, John M.; De Vera, Mary A.
• Is Part Of: Arthritis care & research. Volume 73:Issue 5(2021)
• Page Start: 702
• Page End: 706
• Publication Date: 2021-05-11
• Subjects: Arthritis -- Periodicals; Rheumatism -- Periodicals; 616.72
• DOI: 10.1002/acr.24147
• Languages: English
• ISSNs: 2151-464X

Abstract

Abstract : Objective: To evaluate the association between adherence to antimalarials and type 2 diabetes mellitus (DM) in patients with systemic lupus erythematosus (SLE). Methods: Using administrative health databases in British Columbia, Canada, we conducted a retrospective, longitudinal cohort study of patients with incident SLE and incident antimalarial use. We established antimalarial drug courses by defining a new course when a 90‐day gap is exceeded between refills and we calculated proportion of days covered (PDC) for each course. We categorized medication taking as: 1) adherent (PDC ≥0.90), 2) nonadherent (0 < PDC < 0.90), and 3) discontinuer (no drug). Type 2 DM outcomes were based on outpatient or inpatient visits, or antidiabetic medication use. We used multivariable Cox proportional hazards models with time‐dependent variables. Results: Over a median of 4.62 years of follow‐up in our incident cohort of 1, 498 patients with SLE (90.8% women), we recorded 140 incident cases of type 2 DM. Multivariable hazard ratios were 0.61 (95% confidence interval [95% CI] 0.40–0.93) for adherent and 0.78 (95% CI 0.50–1.22) for nonadherent, respectively, as compared to discontinuers. Conclusion: Our findings of a protective effect of adherence to antimalarials in preventing type 2 DM provides further support for the importance of adherence to antimalarials to obtain the benefits of therapy.