Objective. Cardiovascular disease (CVD) is the leading cause of death in patients with rheumatoid arthritis (RA).Disease-modifying therapies that improve risk factors for CVD, such as dyslipidemia, are desired. This study used an electronic health record to determine if hydroxychloroquine (HCQ) use was associated with an improvement in lipid levels in an inception RA cohort.

1 months (IQR 16.3-65.1 months), respectively (P < 0.001). Of the 91 patients developing diabetes mellitus, 16 were ever and 75 were never TNF␣ inhibitor users, yielding incidence rates of 8.6 and 17.2 per 1,000 person-years (P ‫؍‬ 0.048), respectively. Adjusting for covariates, the hazard ratio for incident diabetes mellitus in TNF␣ inhibitor users was 0.49 (95% confidence interval 0.24 -0.99, P ‫؍‬ 0.049) compared to the never users. Conclusion. In this inception RA cohort, anti-TNF␣ use was associated with a 51% reduction in risk of developing diabetes mellitus.

Objective. To determine the association of tumor necrosis factor ␣ (TNF␣) inhibitors with risk for cardiovascular disease (CVD) in rheumatoid arthritis (RA) patients. Methods. A retrospective cohort of 2,101 incident RA patients was established. Medication exposure was categorized into the following groups: TNF␣ inhibitors alone or in combination with methotrexate (MTX; aTNF group); MTX alone or in combination with other nonbiologic disease-modifying antirheumatic drugs (DMARDs; MTX group); and no MTX, nonbiologic DMARDs (reference group). Primary outcome was adjudicated incident coronary artery disease (CAD), defined as myocardial infarction, unstable angina, or coronary revascularization procedure. Secondary outcome was adjudicated incident CVD, defined as a composite of CAD, stroke, transient ischemic attack, abdominal aortic aneurysm, peripheral arterial disease, or arterial revascularization procedure. Cox regression models were used to calculate the hazard ratio for CAD and CVD for the aTNF and MTX groups compared to the reference group.

Our findings support the potential benefit of hydroxychloroquine in attenuating the risk of diabetes in rheumatoid arthritis patients. Further work is needed to determine its potential preventive role in other groups at high risk for diabetes.

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