Antirheumatic drugs and the risk of nonalcoholic fatty liver disease in patients with rheumatoid arthritis: A nationwide, population-based cohort study

作     者：Meng, Chia-Chu Chen, Der-Yuan Chen, Yi-Hsing Huang, Wen-Nan Chen, Hsin-Hua 

作者机构：Division of Allergy Immunology and Rheumatology Taichung Veterans General Hospital Taichung Taiwan Program in Translational Medicine Rong Hsing Research Center for Translational Medicine National Chung Hsing University Taichung Taiwan Rheumatology and Immunology Center China Medical University Hospital Taichung Taiwan College of Medicine China Medical University Taichung Taiwan Institute of Medicine Chung Shan Medical University Taichung Taiwan Faculty of Medicine National Yang Ming Chiao Tung University Taipei Taiwan Department of Post-Baccalaureate Medicine College of Medicine National Chung Hsing University Taichung Taiwan College of Business and Management Ling Tung University Taichung Taiwan Division of General Medicine Department of Medicine Taichung Veterans General Hospital Taichung Taiwan Program in Translational Medicine and Rong Hsing Research Center for Translational Medi-cine National Chung Hsing University Taichung Taiwan Big Data Center National Chung Hsing University Taichung Taiwan Department of Industrial Engineering and Enterprise Information Tunghai University Taichung Taiwan 

出 版 物：《International Journal of Rheumatic Diseases》 (Int. J. Rheum. Dis.)

年 卷 期：2024年第27卷第1期

页      面：e15003-e15003页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Biostatistics Task Force of Taichung Veterans General Hospital Chiayi Branch, Taichung Veterans General Hospital Ministry of Health and Welfare, MOHW National Health Insurance Administration, NHI National Health Research Institutes, NHRI Taichung Veterans General Hospital, TCVGH, (TCVGH‐VHCY1088605, TCVGH‐VHCY1118604, TCVGH‐VHCY1128603) 

主　　题：incidence medication non-alcoholic fatty liver disease rheumatoid arthritis 

摘      要：Objectives: To assess the association between antirheumatic drugs and of the risk of nonalcoholic fatty liver disease (NAFLD) in a nationwide rheumatoid arthritis (RA) cohort. Methods: Using claim data from the 2000–2020 National Health Insurance Research Database, we identified 21 457 incident patients with RA from 2002 to 2020 without prior liver diseases. A time-varying multivariable Cox regression model was applied to estimate for the association of NAFLD with the use of antirheumatic drugs after adjusting potential confounders, show as adjusted hazard ratios (aHRs) with 95% confidence interval (CIs). Subgroup analyses were conducted based on age-, sex-, and obesity-related comorbidities. Results: Multivariable time-dependent Cox regression analyses showed that defined daily dose (DDD) of NSAID (aHR, 1.03;95% CI: 1.02–1.05) and prednisolone equivalent dose 5 mg/day (aHR, 2.39;95% CI: 1.85–3.09) were risk factors of NAFLD in patients with RA, while prednisolone equivalent dose ≤5 mg/day (aHR of 0.53;95% CI: 0.40–0.71) and HCQ use (aHR of 0.75;95% CI: 0.60–0.93) were associated with a decreased risk of NAFLD. In addition, a history of hospitalizations, number of outpatient visits, age, male, and leflunomide use were associated with the development of NAFLD in some subgroups. Conclusion: This study reveals that NSAID use and prednisolone equivalent dose 5 mg/day were associated with an increased risk of NAFLD in patients with RA, while the use of HCQ and prednisolone equivalent dose ≤5 mg/day decreased the risk of NAFLD. © 2023 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.