Influence of diabetes mellitus on drug continuation rate and treatment efficacy of biologics therapy in rheumatoid arthritis patients

Abstract

    The purpose of this retrospective study was to investigate the influence of diabetes mellitus (DM) on drug continuation rate and treatment efficacy of biologics (BIO) therapy in rheumatoid arthritis (RA) patients. A retrospective single-center study was conducted in patients with RA who started any of BIO between 2003 and 2013 in our institute. Patients were divided into two groups: diabetics (Group D) and non-diabetics (Group N). Baseline characteristics and reasons for discontinuation of BIO were analyzed and compared. Switching one BIO to another was defined as continuation of BIO therapy. Treatment efficacy were assessed and compared at baseline and the last observation day.30 patients for Group D and 215 patients for Group N were studied. Continuation rate of BIO therapy after 1, 3 and 5 years was 76.4%, 68.9%, 41.3% for Group D and 90.5%, 83.6%, 75.2% for Group N (p<0.01). The rate of infection leading to discontinuation of BIO therapy was significantly higher in Group D (16.7% vs. 5.6% p=0.03). Treatment efficacy and QOL at the last observation were significantly worse in Group D, which were similar at baseline. Our data suggest that diabetic RA patients have many risk factors leading to discontinuation of BIO therapy. The higher discontinuation rate of BIO therapy may be the reason for the worse treatment efficacy at the last observation in diabetic RA patients. We conclude that DM is one of the considerable factors when starting the BIO therapy in RA patients.