News

Prednisone Associated With Increased Stroke in RA Patients


 

SAN ANTONIO — Prednisone treatment for rheumatoid arthritis patients was associated with an approximately 50% increased risk of stroke, according to figures from the National Data Bank for Rheumatic Diseases.

Treatment with infliximab was associated with a 50% decreased stroke risk. These findings don't in any way prove cause and effect, the study's lead investigator, Frederick Wolfe, M.D., cautioned in an interview. But they are suggestive of a trend.

They may also challenge some assumptions among providers. “There is a belief that low-dose prednisone is a benign drug treatment,” said Dr. Wolfe of the National Data Bank. “I don't think it is.”

Dr. Wolfe, who presented his findings in a poster presentation at the annual meeting of the American College of Rheumatology, said that his look at the incidence rate of stroke in rheumatoid arthritis (RA) patients was prompted by a request from investigators at the National Institutes of Health, who wanted to know about stroke risk and infliximab treatment. The study used data from 15,670 RA patients and 3,083 osteoarthritis patients, who were followed for a 3-year period ending in 2003.

RA patients had a higher incidence of stroke than did the osteoarthritis patients, with a hazard ratio of 1.26. This increased risk was independent of age, gender, diabetes, and hypertension. The incidence rate in the RA patients was equal to 8 cases per 1,000 patient-years.

Among the RA patients, stroke risk was increased in those on prednisone, with a hazard ratio of 1.52, and decreased in those on infliximab, with a hazard ratio of 0.49. Concurrent methotrexate therapy did not appear to have an impact on risk of stroke.

Sulfasalazine treatment was also found to be associated with a 50% decreased risk; however, there were too few patients in the group who took sulfasalazine for that finding to be considered statistically significant, Dr. Wolfe noted.

Recommended Reading

Pioglitazone Beat Rosiglitazone In Lipid Level Improvement
MDedge Internal Medicine
Simvastatin, Pravastatin Lower Blood Pressure
MDedge Internal Medicine
High Folate Linked to Lower Risk Of Hypertension in Young Women
MDedge Internal Medicine
Body Mass Index Affects CV Event Rate in Hypertensives
MDedge Internal Medicine
Nomogram Calculates Women's Exercise Capacity
MDedge Internal Medicine
Family History of Heart Disease Boosts Coronary Risk in Sisters
MDedge Internal Medicine
Heart Disease Prevention Efforts Should Target Women in Midlife
MDedge Internal Medicine
Drugs, Methods Poised To Change Imaging
MDedge Internal Medicine
Coronary Calcium Screening Backed for High-Risk Patients
MDedge Internal Medicine
Normal Stress Echo Good for 18 Months in Patients With Prior MI
MDedge Internal Medicine