Adherence to lupus medications associated with lower diabetes risk
The results of a retrospective, population-based study suggest that individuals with lupus who adhere to their antimalarial treatment regimens face reduced risks of developing Type 2 diabetes, which is a common complication associated with the disease.
The results of a retrospective, longitudinal study, conducted by researchers from the University of British Columbia (Vancouver, Canada), suggest that individuals with systemic lupus erythematosus (lupus) who adhere to their antimalarial treatment regimens face reduced risks of developing Type 2 diabetes, which is a common complication associated with the disease.
Lupus is an autoimmune condition that affects approximately 5 million individuals globally. There is no known cure for the disease, which induces inflammation in multiple organs and causes symptoms such as fatigue, facial rashes and joint pain.
Antimalarial drugs are commonly prescribed for the long-term treatment of lupus symptoms, however, previous research has suggested that 43–75% of individuals with lupus do not take their medications as prescribed.
In this study, researchers utilized administrative health databases and analyzed data on prescription refill times, healthcare visits and hospitalizations of 1498 individuals with lupus in British Columbia, over a 4-year period.
Investigators defined a course when a 90‐day gap between antimalarial prescription refills was exceeded, allowing researchers to establish antimalarial drug courses and calculate the proportion of days individuals were covered by treatments during each course. This allowed researchers to define medication-adherent study participants as those with calculated proportions of days covered of least 90%, and non‐adherent study participants with calculated proportions of days covered of less than 90%.
Incidence of Type 2 diabetes was defined by outpatient or inpatient visits, or use of an antidiabetic medication. Multivariable Cox’s proportional hazards models were employed to evaluate time‐dependent association between antimalarial medication adherence and Type 2 diabetes incidence.
The results of the study demonstrate that compared with individuals who discontinued use of their antimalarial medications – termed ‘non-users’ – the hazard ratios of developing Type 2 diabetes were 0.61 for participants who adhered to their treatment regimens, and 0.78 for non-adherent study participants.
Senior study author Mary de Vera (University of British Columbia) stated: “For people with lupus, preventing Type 2 diabetes is critical. Diabetes can lead to many other complications such as neuropathy, cardiovascular disease and kidney failure. Given the clear implications of non-adherence to lupus treatment, future research should focus on developing and testing ways to improve antimalarial adherence.”
Salmasi S, Sayre EC, Avina‐Zubieta JA, Esdaile JM, de Vera MA. Adherence to anti-malarial therapy and risk of Type 2 diabetes mellitus among patients with systemic lupus erythematosus: a population‐based study. Arthritis Care Res. doi:10.1002/acr.24147 (2020) (Epud ahead of print);