Article Text
Abstract
Objectives Population studies on hearing loss (HL) associated with rheumatoid arthritis (RA) are lacking. This study investigated the risk of developing HL in patients with RA using a nationwide population cohort.
Setting The population-based insurance claims data in the Taiwan National Health Insurance Research Database.
Design Retrospective cohort study followed up RA cohort and control cohort without RA frequency matched by sex, age and diagnosis year.
Study population 18 267 patients with RA newly diagnosed in 2000–2006 and 73 068 controls without RA.
Main outcomes Incidences of HL by the end of 2011 and the RA cohort to non-RA cohort HRs after adjusting for sex, age and comorbidities.
Results The HL incidence was higher in the RA cohort than in the non-RA cohort (3.08 vs 1.62 per 1000 person-years), with an adjusted HR (aHR) of 1.91 (95% CI 1.70 to 2.14) for the RA cohort relative to the non-RA cohort after controlling for age, sex and comorbidities. Men and the elderly are at a higher risk. Cardiovascular comorbidities were associated with a further increased HL risk for patients with RA. Medications were associated with reduced HL incidence; patients with RA who used non-steroidal anti-inflammatory drugs (NSAIDs) had an aHR of 0.12 (95% CI 0.07 to 0.20), compared with non-users.
Conclusions This study demonstrates that patients with RA are at an increased risk of developing HL. Findings highlight the need of disease-modifying treatment and scheduled auditory examinations for HL prevention and early detection for patients with RA.
- rheumatoid arthritis
- hearing loss
- insurance data,
- retrospective cohort study
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Footnotes
Contributors The paper was conceived by C-MH, H-JC, P-HH, GJT and J-LL. C-MH, H-JC and F-CS wrote the first draft, with further contributions from all authors. Statistical analyses were undertaken by C-MH, H-JC and F-CS. C-MH and F-CS revised the article. All authors contributed to data interpretation and reviewed and approved the final version of the manuscript.
Funding This study was supported by the Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW106-TDU-B-212-113004); China Medical University Hospital; Academia Sinica Taiwan Biobank, Stroke Biosignature Project (BM10601010036); Taiwan Clinical Trial Consortium for Stroke (MOST 106-2321-B-039-005); Tseng-Lien Lin Foundation, Taichung, Taiwan; Taiwan Brain Disease Foundation, Taipei, Taiwan and Katsuzo and Kiyo Aoshima Memorial Funds, Japan.
Competing interests None declared.
Ethics approval Research Ethics Committee of China Medical University Hospital (CMUH104-REC2-115).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.