Risk of Serious Infection With Low-dose Glucocorticoids in Patients With Rheumatoid Arthritis: An Instrumental Variable Analysis.

ABSTRACT:

Background

Low-dose glucocorticoids are commonly used in the treatment of rheumatoid arthritis (RA). Observational studies have found an increased risk of serious infection associated with low-dose glucocorticoids, but concerns about residual confounding remain.

Methods

We identified adults with RA on stable immunomodulatory therapy for >6 months receiving no glucocorticoids or ≤5 mg/day using Medicare data from 2006 to 2015. We used provider preference for glucocorticoids as an instrumental variable (IV) to assess associations between low-dose glucocorticoid use and the risk of infection requiring hospitalization using a cause-specific proportional hazards model.

Results

We identified 163,603 qualifying treatment episodes among 120,656 patients. Glucocorticoids ≤5 mg

SUBMITTER: George MD 

PROVIDER: S-EPMC8633063 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature