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Risk of Diabetes in Patients With Rheumatoid Arthritis Taking Hydroxychloroquine
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To the Editor: In their multicenter study of the association between treatment with hydroxychloroquine and the risk of diabetes mellitus, Dr Wasko and colleagues1 followed up a large cohort of patients with rheumatoid arthritis for 21.5 years. After adjustment for diabetes risk factors and prednisone use, the authors concluded that treatment with hydroxychloroquine was associated with a reduced risk of developing diabetes. The use of prednisone was evaluated as "ever" or "never" and the percentage of time using the drug during the observation period was calculated.
We believe that to correctly evaluate the contribution of prednisone to the incidence of diabetes, the cumulative dose of the drug has to be determined. Hydroxychloroquine has been shown to reduce the signs and symptoms of rheumatoid arthritis; therefore, patients taking this additional drug are likely to require lower doses of prednisone.2 Furthermore, Wasko et al state that patients who had not taken hydroxychloroquine . . . [Full Text of this Article]
Gabriele Di Comite, MD
dicomite.gabriele@hsr.it
Carlo M. Rossi, BS
Vita-Salute San Raffaele University
Milan, Italy
RELATED LETTER
Risk of Diabetes in Patients With Rheumatoid Arthritis Taking Hydroxychloroquine—Reply
Mary Chester M. Wasko, Helen B. Hubert, Vijaya Bharathi Lingala, Jennifer Rae Elliott, Michael E. Luggen, James F. Fries, and Michael M. Ward
JAMA. 2007;298(20):2369-2370.
EXTRACT
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RELATED ARTICLE
Hydroxychloroquine and Risk of Diabetes in Patients With Rheumatoid Arthritis
Mary Chester M. Wasko, Helen B. Hubert, Vijaya Bharathi Lingala, Jennifer R. Elliott, Michael E. Luggen, James F. Fries, and Michael M. Ward
JAMA. 2007;298(2):187-193.
ABSTRACT
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