Is Type 2 Diabetes Linked to Increased Risk of Rheumatoid Arthritis?

Sarfaroj Khan 


February 19, 2021


  • This study found a reduced risk of rheumatoid arthritis (RA) that was potentially attributable to the use of statin in patients with type 2 diabetes (T2D).

  • The use of metformin and dipeptidyl peptidase-4 inhibitor (DPP4i) did not influence the risk of RA in patients with T2D.   

Why this matters

  • Findings warrant further investigation in a trial setting to assess whether statins can prevent the development of RA in individuals at high risk of RA.

Study design

  • This retrospective cohort study included 224,551 newly diagnosed patients with T2DM and 449,101 matched patients without T2D from the IQVIA medical research database (IMRD-UK; 1995-2019).

  • Funding: MRC Versus Arthritis Centre for Musculoskeletal Ageing Research.

Key results

  • Patients with T2D had a reduced risk of developing RA vs those without T2D (incidence rate, 8.1 vs 10.6 per 10,000 person-years; adjusted HR [aHR], 0.73; 95% CI, 0.67-0.79).

  • After excluding all patients who had a history of statin use, the aHR increased to 0.89 (95% CI, 0.69-1.14; P=.34), and no significant difference was seen between the groups.

  • No significant association was seen between glycaemic control (aHR, 1.00; 95% CI, 0.99-1.00), use of metformin (aHR, 1.00; 95% CI, 0.82-1.22), DPP4i (aHR, 0.94; 95% CI, 0.71-1.24) and the risk of RA.

  • Statin use was associated with a reduced risk of RA in patients with T2D (aHR, 0.76; 95% CI, 0.66-0.88).

  • In a duration-response analysis for statin use, aHRs for risk of RA was evident only after 3 years’ worth of prescription (3-4.5 years: aHR, 0.77; 95% CI, 0.57-1.05) and ≥4.5 years (aHR, 0.75; 95% CI, 0.57-0.98).


  • Retrospective design.


Zemedikun DT, Gokhale K, Chandan JS, Copper J, Lord JM, Filer A, Falahee M, Nirantharakumar K, Raza K. Type 2 diabetes mellitus, glycaemic control, associated therapies and risk of rheumatoid arthritis: a retrospective cohort study. Rheumatology (Oxford). 2021 Feb 16 [Epub ahead of print]. doi: 10.1093/rheumatology/keab148. PMID: 33590842 View abstract

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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