AB1276 THE RISK OF DIABETES MELLITUS IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS: A COHORT STUDY

Background

Few studies have suggested higher prevalence of type 1 diabetes mellitus (DM) in juvenile idiopathic arthritis (JIA). To date, the risk of type 1 or 2 DM among patients with JIA patients has not been fully understood.

Objectives

To examine the incidence rate (IR) of DM in JIA patients compared to patients with asthma and healthy children.

Methods

We conducted a cohort study using a U.S. claims data from Truven MarketScan (2005-2016). We identified individuals between age 6 and 18 with ≥2 diagnoses of JIA with International Classification of Diseases (ICD)-9 and 10 diagnostic codes followed by one dispensing of JIA-treatment medication. For comparison, we selected 1) children with asthma and 2) healthy individuals. Each JIA patient was matched by age, sex and index date to 5 asthma patients and 5 healthy children. The primary outcome was DM, identified with 1 ICD diagnostic code followed by one dispensing of an antidiabetic drug. We assessed type 1 DM and type 2 DM separately, and composite endpoint of type 1 or 2 DM. IR and hazard ratio (HR) of DM in JIA patients versus patients with asthma and healthy subjects was calculated along with stratification by age (6 to 12 versus 13 to 18).

Results

After 1:5 matching, there were 74,385 healthy children, 74,385 asthma patients, and 14,877 JIA patients. The mean age in all cohorts was 13.9 years and 66.9% were female. During a mean follow up of 3.72 years, the composite IR of DM in the JIA group was 0.85 per 1,000 person-years (95% Confidence Interval [CI], 0.61-1.19) compared to 0.63 (0.54-0.74) per 1,000 person-years in the asthma population and 0.53 (0.45-0.62) per 1,000 person-years in the healthy population (Table 1). The multivariable adjusted HR (95% CI) associated with DM in JIA was 1.27 (0.77-2.07) compared to the asthma group and 1.47 (0.90-2.42) compared to the healthy population (Table 2). Age-stratified analyses also showed numerically increased risk of DM in JIA patients. † The study cohorts were age-, sex-, and index date-matched. IR is per 1,000 person-years

Conclusion

In our cohort of 163,647 children with 14,877 JIA patients, JIA was associated with a numerically higher, albeit not statistically significant, risk of type 1 or 2 DM compared to asthma patients or healthy children.

References

[1] Schenck S, et al. Comorbidity of Type 1 Diabetes Mellitus in Patients with Juvenile Idiopathic Arthritis. The Journal of pediatrics. Jan 2018;192:196-203.

Acknowledgement

This study was supported by an investigator-initiated research grant from Bristol-Myer-Squibb.

Disclosure of Interests

Hemin Lee: None declared, Yinzhu Jin: None declared, Jun Liu: None declared, Ezra Cohen: None declared, Sarah Chen: None declared, Seoyoung Kim Grant/research support from: Pfizer, Bristol-Myers Squibb, Roche/Genentech and AbbVie.