Oct 23, 2010

The incidence of gastrointestinal perforations among rheumatoid arthritis patients

Arthritis and Rheumatism
Jeffrey R CurtisElizabeth Delzell

Abstract

Gastrointestinal (GI) perforation has emerged as a novel safety concern in relation to medications used to treat rheumatoid arthritis (RA). This study was undertaken to characterize the incidence and risk factors for GI perforation in RA patients. Using administrative databases of a large US health plan, we identified RA patients treated with biologic agents, methotrexate (MTX), oral glucocorticoids, and nonsteroidal antiinflammatory drugs (NSAIDs). Additional risk factors we evaluated included diverticulitis. Hospitalization with GI perforation was identified using a validated algorithm. Incidence rates and risk factors were evaluated using Cox proportional hazards models. Among 40,841 RA patients, 37 hospitalizations with GI perforation were identified. The rate of GI perforation among patients currently being treated with biologic agents who were also receiving oral glucocorticoids was higher (1.12 per 1,000 person-years [95% confidence interval (95% CI) 0.50-2.49]) than for patients being treated with biologic agents who were not also receiving glucocorticoids (0.47 per 1,000 person-years [95% CI 0.22-0.98]) or for patients being treated with MTX who were also receiving glucocorticoids (0.87 per 1,000 person-years [95% CI 0...Continue Reading

Mentioned in this Paper

Antirheumatic Drugs, Disease-Modifying
Glucocorticoid inhalants for obstructive airway disease
Intestinal Perforation
Anti-Inflammatory Agents, Non-Steroidal
Glucocorticoids, Systemic
Adverse Event
Rheumatoid Arthritis
Gastrointestinal Perforation
Glucocorticoid Effect
Comorbidity

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