Disease-modifying antirheumatic drugs (DMARDs) may lower diabetes (DM) risk in patients with rheumatoid arthritis (RA) or psoriasis, according to a study published in the June 22 issue of the Journal of the American Medical Association.
Disease-modifying antirheumatic drugs (DMARDs) may lower diabetes (DM) risk in patients with rheumatoid arthritis (RA) or psoriasis, according to a study published in the June 22 issue of the Journal of the American Medical Association.
Researchers examined the relationship between newly recorded DM among 121,280 patients with a diagnosis of RA or psoriasis on at least 2 visits and their use of a variety of disease-modifying antirheumatic drugs (DMARDs). Administrative data from patients enrolled in 2 large health insurance programs-1 in Canada and 1 in the United States - were analyzed over a mean follow-up time of 5.8 months from the first DMARD prescription after study eligibility. Study duration was from January 1996 through June 2008, and patients were observed until they experienced an outcome, died, disenrolled from the health plan, or follow up ended.
To measure newly diagnosed DM and the use of a DM-specific medication, 4 mutually exclusive groups of DMARDs were defined:
(1) tumor necrosis factor (TNF) inhibitors with or without any other nonbiologic DMARDs;
(2) methotrexate without TNF inhibitors or hydroxychloroquine;
(3) hydroxychloroquine without TNF inhibitors or methotrexate; or
(4) other nonbiologic DMARDs without TNF inhibitors, methotrexate, or hydroxychloroquine.
The investigators concluded that the use of a TNF inhibitor or hydroxychloroquine but not methotrexate was associated with a reduced risk of DM compared with other nonbiologic DMARDs among patients with RA or psoriasis.
The researchers found that the incidence rate of DM was reduced in users of TNF inhibitors and hydroxychloroquine, compared with other nonbiologic DMARDs. They also found a suggestion of a reduced risk with methotrexate. The findings were consistent across a variety of sensitivity analyses, the authors noted.
“Considering these results in light of prior findings regarding improved insulin and glucose metabolism and reduced DM risk with hydroxychloroquine and TNF inhibitors, there is evidence suggesting a possible role for DMARDs and immunosuppression in DM prevention,” the authors wrote, noting that their findings should be considered hypothesis-generating and that future studies might address ability of these agents to prevent DM among patients with systemic inflammatory disorders.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.