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The association between gastro-oesophageal reflux disease and subsequent rheumatoid arthritis occurrence: a nested case–control study from Taiwan
- Source :
- BMJ Open
- Publication Year :
- 2017
- Publisher :
- BMJ Publishing Group, 2017.
-
Abstract
- ObjectiveGastro-oesophageal reflux disease (GORD) is a common comorbidity among patients with rheumatoid arthritis (RA). While GORD has been attributed to the antirheumatic medications, no studies of human cohorts have investigated a link between GORD and RA. This study investigates whether GORD is associated with a subsequent RA diagnosis over a 5-year follow-up using a population-based dataset.SettingTaiwanParticipantsWe used data from the Taiwan Longitudinal Health Insurance Database. The study group consisted of 13 645 patients with an ambulatory claim showing a GORD diagnosis. We used propensity score matching to select 13 645 comparison patients (one per study patient with GORD).InterventionWe tracked each patient’s claims over a 5-year period to identify those who subsequently received a diagnosis of RA. Cox proportional hazard (PH) regression modelling was used for analysis.ResultsOver 5-year follow-up, RA incidence rate per 1000 person-years was 2.81 among patients with GORD and 0.84 among the comparison group. Cox PH modelling showed that GORD was independently associated with a 2.84-fold increased risk of RA (95% CI 2.09 to 3.85) over 5-year follow-up, after adjusting for the number of ambulatory care visits within the year following the index date (to mitigate surveillance bias).ConclusionsWe observed that GORD might associate with subsequent RA occurrence. Because current treatment guidelines for RA emphasise early diagnosis and prompt treatment, the observed association between GORD and RA may help acquaint clinicians to patients with GORD with higher RA risk and facilitate early diagnosis and treatment.
- Subjects :
- 0301 basic medicine
rheumatoid arthritis
Adult
Male
medicine.medical_specialty
Epidemiology
gastroesophageal reflux disease
Population
Taiwan
Comorbidity
Arthritis, Rheumatoid
03 medical and health sciences
0302 clinical medicine
Ambulatory care
Internal medicine
medicine
otorhinolaryngologic diseases
Humans
education
Propensity Score
Aged
Proportional Hazards Models
030203 arthritis & rheumatology
education.field_of_study
business.industry
Research
Incidence
digestive, oral, and skin physiology
General Medicine
Middle Aged
medicine.disease
digestive system diseases
030104 developmental biology
Rheumatoid arthritis
Case-Control Studies
Propensity score matching
Nested case-control study
GERD
Gastroesophageal Reflux
Female
business
Subjects
Details
- Language :
- English
- ISSN :
- 20446055
- Volume :
- 7
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- BMJ Open
- Accession number :
- edsair.doi.dedup.....085b5803e3634e6fdfd84bff67c95535