Hydroxychloroquine and risk of osteoporosis in patients with rheumatoid arthritis: A population-based retrospective study of 6408 patients

IF 2.4 4区医学 Q2 RHEUMATOLOGY

International Journal of Rheumatic Diseases Pub Date : 2024-08-18 DOI:10.1111/1756-185X.15286

Chen Dong, Brian Shiian Chen, Chun Hsien Wu, Yi-Ming Chiu, Pei-Lun Liao, Wuu-Tsun Perng

{"title":"Hydroxychloroquine and risk of osteoporosis in patients with rheumatoid arthritis: A population-based retrospective study of 6408 patients","authors":"Chen Dong, Brian Shiian Chen, Chun Hsien Wu, Yi-Ming Chiu, Pei-Lun Liao, Wuu-Tsun Perng","doi":"10.1111/1756-185X.15286","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>Patients with rheumatoid arthritis (RA) are at a higher risk of osteoporotic fractures. Studies have shown that patients with Sjogren's syndrome (SS) and systemic lupus erythematosus (SLE) experienced an increase in bone mineral density (BMD) after receiving hydroxychloroquine (HCQ) treatment, indicating a potential protective effect against osteoporosis. Therefore, this study is to examine the relationship between HCQ usage and the risk of osteoporosis in patients diagnosed with RA.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>The retrospective cohort study used data from Taiwan's National Health Insurance Research Database (NHIRD) covering the period from January 2010 to December 2018, which included 14 050 newly diagnosed RA patients, subsequently divided into two groups: HCQ users and non-users. Propensity score matching (PSM) based on sex, age, urbanization, insured unit type, insured area, and comorbidities was conducted to match the groups. The primary outcome assessed was the evaluation of the risk of osteoporosis by employing a multivariable Cox proportional hazard regression model to calculate the adjusted hazard ratio (aHR).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>After PSM, a total of 6408 RA patients were included in the analysis (3204 HCQ users and 3204 non-users). There was no significantly higher risk of osteoporosis in HCQ users compared with non-users, aHR = 0.99 (95% CI: 0.82–1.196). Additionally, different durations of HCQ usage demonstrated a neutral effect on the risk of osteoporosis [HCQ <90 days, aHR = 0.88 (95% CI: 0.585–1.324); HCQ 90–180 days, aHR = 0.941 (95% CI: 0.625–1.418); HCQ >180 days, aHR = 1.019 (95% CI: 0.832–1.249)].</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The study indicates that there is no significant association between the use of HCQ and the risk of osteoporosis in patients with RA.</p>\n </section>\n </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"27 8","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Rheumatic Diseases","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/1756-185X.15286","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Aim

Patients with rheumatoid arthritis (RA) are at a higher risk of osteoporotic fractures. Studies have shown that patients with Sjogren's syndrome (SS) and systemic lupus erythematosus (SLE) experienced an increase in bone mineral density (BMD) after receiving hydroxychloroquine (HCQ) treatment, indicating a potential protective effect against osteoporosis. Therefore, this study is to examine the relationship between HCQ usage and the risk of osteoporosis in patients diagnosed with RA.

Methods

The retrospective cohort study used data from Taiwan's National Health Insurance Research Database (NHIRD) covering the period from January 2010 to December 2018, which included 14 050 newly diagnosed RA patients, subsequently divided into two groups: HCQ users and non-users. Propensity score matching (PSM) based on sex, age, urbanization, insured unit type, insured area, and comorbidities was conducted to match the groups. The primary outcome assessed was the evaluation of the risk of osteoporosis by employing a multivariable Cox proportional hazard regression model to calculate the adjusted hazard ratio (aHR).

Results

After PSM, a total of 6408 RA patients were included in the analysis (3204 HCQ users and 3204 non-users). There was no significantly higher risk of osteoporosis in HCQ users compared with non-users, aHR = 0.99 (95% CI: 0.82–1.196). Additionally, different durations of HCQ usage demonstrated a neutral effect on the risk of osteoporosis [HCQ <90 days, aHR = 0.88 (95% CI: 0.585–1.324); HCQ 90–180 days, aHR = 0.941 (95% CI: 0.625–1.418); HCQ >180 days, aHR = 1.019 (95% CI: 0.832–1.249)].

Conclusions

The study indicates that there is no significant association between the use of HCQ and the risk of osteoporosis in patients with RA.

查看原文本刊更多论文

羟氯喹与类风湿关节炎患者骨质疏松症的风险：一项对 6408 名患者进行的基于人群的回顾性研究。

目的：类风湿性关节炎（RA）患者发生骨质疏松性骨折的风险较高。研究表明，斯约格伦综合征（SS）和系统性红斑狼疮（SLE）患者在接受羟氯喹（HCQ）治疗后，其骨矿物质密度（BMD）会增加，这表明羟氯喹对骨质疏松症具有潜在的保护作用。因此，本研究旨在探讨使用 HCQ 与确诊为 RA 患者的骨质疏松症风险之间的关系：该回顾性队列研究使用了台湾国民健康保险研究数据库（NHIRD）中2010年1月至2018年12月期间的数据，纳入了14050名新确诊的RA患者，随后将其分为两组：HCQ使用者和非使用者。根据性别、年龄、城市化程度、参保单位类型、参保地区和合并症等因素进行倾向得分匹配（PSM），对两组进行匹配。评估的主要结果是采用多变量考克斯比例危险回归模型计算调整后的危险比（aHR），评估骨质疏松症的风险：经过PSM分析，共有6408名RA患者被纳入分析（3204名使用HCQ，3204名未使用HCQ）。与未使用 HCQ 的患者相比，使用 HCQ 的患者发生骨质疏松症的风险并无明显增加，aHR = 0.99 (95% CI: 0.82-1.196)。此外，使用 HCQ 的不同持续时间对骨质疏松症的风险没有影响[HCQ 180 天，aHR = 1.019 (95% CI: 0.832-1.249)]：该研究表明，RA 患者使用 HCQ 与骨质疏松症风险之间没有明显关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Rheumatic Diseases RHEUMATOLOGY-

CiteScore

3.70

自引率

4.00%

发文量

362

审稿时长

1 months

期刊介绍： The International Journal of Rheumatic Diseases (formerly APLAR Journal of Rheumatology) is the official journal of the Asia Pacific League of Associations for Rheumatology. The Journal accepts original articles on clinical or experimental research pertinent to the rheumatic diseases, work on connective tissue diseases and other immune and allergic disorders. The acceptance criteria for all papers are the quality and originality of the research and its significance to our readership. Except where otherwise stated, manuscripts are peer reviewed by two anonymous reviewers and the Editor.