ArticleBMC rheumatology2020
The effect of glucocorticoid therapy on mortality in patients with rheumatoid arthritis and concomitant type II diabetes: a retrospective cohort study.
Article in BMC rheumatology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 14 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- European Society of Endocrinology and Endocrine Society Joint Clinical Guideline: Diagnosis and Therapy of Glucocorticoid-induced Adrenal Insufficiency.The Journal of clinical endocrinology and metabolism · 2024Guideline
- Polypharmacy and Bone Health in Patients with Type 2 Diabetes Mellitus: A Narrative Review.Journal of bone metabolism · 2026Article
- Survival Outcomes and Prognostic Factors in Rheumatoid Arthritis Patients Receiving Biologic or Targeted Synthetic Therapy: Real-World Data.Antibodies (Basel, Switzerland) · 2025Article
- Morning serum cortisol as a predictor of synacthen stimulation test outcomes during corticosteroid withdrawal: a comparative analysis of high-dose and low-dose protocols.Frontiers in endocrinology · 2025Article
- Hypothalamic-Pituitary-Adrenal Axis Activity and Metabolic Disorders in Kidney Transplant Recipients on Long-Term Glucocorticoid Therapy.Journal of clinical medicine · 2024Article
- Integrated multi-omics revealed that dysregulated lipid metabolism played an important role in RA patients with metabolic diseases.Arthritis research & therapy · 2024Article
- Association of Cardiovascular Outcomes With Low-Dose Glucocorticoid Prescription in Patients With Rheumatoid Arthritis.Arthritis & rheumatology (Hoboken, N.J.) · 2024Article
- Bridging Gaps Amidst Limited Evidence for Glucocorticoid-Induced Adrenal Insufficiency.Endocrinology and metabolism (Seoul, Korea) · 2024Article
- Role and uptake of metal-based nanoconstructs as targeted therapeutic carriers for rheumatoid arthritis.3 Biotech · 2024Review
- Risk factors for type 2 diabetes mellitus in Chinese rheumatoid arthritis patients from 2018 to 2022: a real-world, single-center, retrospective study.Frontiers in immunology · 2024Article
- Clinical characteristics of adrenal crisis in 371 adult patients with glucocorticoid-induced adrenal insufficiency.Frontiers in endocrinology · 2024Article
- Clinical Features of Diabetes Mellitus on Rheumatoid Arthritis: Data from the Cardiovascular Obesity and Rheumatic DISease (CORDIS) Study Group.Journal of clinical medicine · 2023Article
- Glucocorticoid and opioid use in rheumatoid arthritis management.Current opinion in rheumatology · 2021Review
- Correction to: The effect of glucocorticoid therapy on mortality in patients with rheumatoid arthritis and concomitant type II diabetes: a retrospective cohort study.BMC rheumatology · 2021Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundPatients with rheumatoid arthritis (RA) have increased cardiovascular (CV) and mortality risk. Patients with RA are also frequently prescribed glucocorticoids (GCs) which have been associated with increased risk of mortality. In addition, for patients who have concomitant diabetes mellitus (DM), GCs are known to worsen glycaemic control and hence may further increase CV and mortality risk. This study aimed to understand the relationship between GCs, DM and mortality in patients with RA.
methodsThis was a retrospective cohort study of patients with incident RA identified from UK primary care electronic medical records. Patients with linkage to Office for National Statistics (ONS) for mortality data (
resultsIn those without DM GC use had a 4.4-fold increased all-cause mortality RR (95% confidence interval (CI): 3.83 to 5.14) compared to non-use, whilst those with DM had a lower RR for GC use (3.02 (95% CI: 2.34, 3.90)). However, those with DM had a higher RD associated with GC use because of their higher baseline risk. In those with DM, GC use was associated with an additional 46.7 deaths/1000 person-years (pyrs) (95% CI: 34.1 to 59.3) compared to non-use, while in those without DM GC use was associated with an additional 36.2 deaths/1000 pyrs (95% CI: 31.6 to 40.8). A similar pattern was seen for CV mortality. The adjusted Cox proportional hazards model showed no evidence of multiplicative interaction, but additive interaction indicated a non-significant increased risk. For CV mortality there was no interaction on either scale.
conclusionsGC use was associated with higher mortality rates in people with comorbid DM compared to people without DM, despite apparently reassuring similar relative risks. Clinicians need to be aware of the higher baseline risk in patients with DM, and consider this when prescribing GCs in patients with RA and comorbid DM.
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