biostudies-literatureGeorge MDNIAMS NIH HHS65-74https://www.ebi.ac.uk/biostudies/studies/S-EPMC8633063biostudies-literatureUnknown33(1)<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>We identified 163,603 qualifying treatment episodes among 120,656 patients. Glucocorticoids ≤5 mgEpidemiology (Cambridge, Mass.)Risk of Serious Infection With Low-dose Glucocorticoids in Patients With Rheumatoid Arthritis: An Instrumental Variable Analysis.PMC8633063K23 AR073931Hsu JYXie FChen LBaker JFCurtis JRHennessy SGeorge MDfalseRisk of Serious Infection With Low-dose Glucocorticoids in Patients With Rheumatoid Arthritis: An Instrumental Variable Analysis.<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>We identified 163,603 qualifying treatment episodes among 120,656 patients. Glucocorticoids ≤5 mg2022-01-01T00:00:00Z2022 Jan2025-04-04T13:40:20.534Z2025-04-04T13:40:20.534ZS-EPMC86330633456134810.1097/ede.000000000000142210.1097/EDE.0000000000001422