Aspirin, Metformin, and Statin Use on the Risk of Gastric Cancer in a High-Risk Region: A Nationwide Population-Based Cohort Study in Korea with Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Seung In Seo ◽  
Chan Hyuk Park ◽  
Tae Joon Kim ◽  
Chang Seok Bang ◽  
Jae Young Kim ◽  
...  
2016 ◽  
Vol 45 ◽  
pp. 71-81 ◽  
Author(s):  
Ronan T. Gray ◽  
Helen G. Coleman ◽  
Carmel Hughes ◽  
Liam J. Murray ◽  
Chris R. Cardwell

2021 ◽  
Vol 6 (1) ◽  
pp. 5
Author(s):  
Greta Charukevič ◽  
Dalia Miltinienė ◽  
Jolanta Dadonienė

Background and Objectives: Mortality rates among patients with rheumatoid arthritis (RA) have been reported to be higher than in the general population. The long-term prognosis of RA has improved in recent years due to early diagnosis, as well as effective pharmacological treatment, and this may be able to diminish the excess mortality risk. This study was designed to investigate mortality (a) in patients with RA in a retrospectively defined national RA cohort in comparison with the general Lithuanian population, and (b) to conduct a systematic review of the literature from different countries and meta-analysis. Materials and Methods: In this national retrospective cohort study, patients with a first-time diagnosis of RA in the period between 1 January 2013 and 31 December 2017 were identified from the Lithuanian Compulsory Health Insurance Information System database SVEIDRA. All cases were cross-checked with the Health Information Center at the Institute of Hygiene, for the vital status of these patients and date of death if documented. The standardized mortality ratios (SMRs) with 95% confidence intervals (CI) obtained for all-cause mortality in patients with RA adjusted for age, sex, and calendar year were calculated. The search for published studies using the combination of keywords “rheumatoid arthritis AND standardized mortality ratio” was performed in MEDLINE (via PubMed, OVID, and EBSCO), Science Direct, Taylor & Francis, and Springer databases. Studies were selected according to described inclusion and exclusion criteria listed in the paper, and a meta-analysis was conducted. A random-effect meta-analysis model was used to compute the pooled standardized mortality ratios (meta-SMRs). Results: Overall, 4623 patients with newly diagnosed RA during the 2013–2017 period were identified and enrolled in the Lithuanian population-based cohort. The mean age of patients at the time of RA diagnosis was 58.7 (standard deviation (SD) 15.1) years, and 77.1% of the patients were women. The estimated SMR for all-cause mortality was 1.15 (95% CI 1.02, 1.29). The SMR for men (SMR 1.14, 95% CI 0.94, 1.39) was higher than for women (SMR 1.03, 95% CI 0.89, 1.19). A systematic literature search revealed 12 studies meeting the inclusion criteria, starting from 2010 to 2020, representing 50,072 patients. The meta-SMR in patients with RA for all-cause mortality was 1.41 (95% CI 1.29, 1.55). All-cause mortality risk was higher for men (meta-SMR 1.53, 95% CI 1.31, 1.78) than for women (meta-SMR 1.46, 95% CI 1.2, 1.77). Conclusions: In a retrospectively defined population-based national RA cohort, a 15% excess risk of death was observed among patients with RA compared to the general Lithuanian population. Patients with RA have a higher mortality risk than the general population. Published data indicate that the risk of mortality is increased by 41% in patients with RA compared to the general population. Excessive all-cause mortality risk is higher in men than in women. National data showed lower standardized mortality compared to literature data.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 462.2-463
Author(s):  
M. Turk ◽  
A. Gorman ◽  
K. Murray ◽  
Y. Alammari ◽  
F. Young ◽  
...  

Background:The effect of alcohol on disease activity in inflammatory arthritis remains poorly understood. Studies of alcohol and the incidence or risk of inflammatory arthritis are conflicting [1,2]. Alcohol does downregulate pro-inflammatory cytokines and may therefore reduce immune-mediated disease activity.Objectives:This study investigates the relationship between alcohol consumption and disease activity in our inflammatory arthritis patient cohort and performs a systematic review with meta-analysis.Methods:Cohort Study Design and data analysisPatients attending a rheumatology clinic between 2010-2020 were prospectively followed. Information on demographics, alcohol use, smoking habits, and disease outcome measures were collected. Statistical analysis included univariate and multivariate linear and binary logistic regressions, Mann Whitney-U tests, and one-way ANOVA with Tukey’s HSD.Meta-analysisEMBASE, Pubmed, the Cochrane library, and Web of Science were searched. Studies reporting on alcohol consumption and disease activity in a cohort of RA patients were included for further investigation. Forest plots were generated from 95% confidence intervals of extracted data using mean differences. Linear regression was used to determine correlations between alcohol and antibody status, gender, and smoking status.Results:Cohort StudyOf the 979 analysed patients, 62% had RA, 26.7% had PsA, and 11.2% had AS. Mean DAS28-CRP in RA and PsA at one year was 2.96 ± 1.39, and 64.2% of patients were in remission (DAS28-CRP ≤ 2.6 or BASDAI ≤ 4). Both male gender and risky drinking (>15 units of weekly alcohol) were both significantly associated with remission. Compared to women, men had an odds ratio of 1.78 [1.04, 2.52] (p=0.034) for any alcohol consumption and 6.9 [4.7, 9.1] (p=0.001) for drinking at least 15 weekly drinks. when adjusted for gender, there was no significant association between alcohol and disease activity. Yet, when adjusted for alcohol consumption, gender still influenced disease activity.Meta-analysisThe search identified 4126 citations of which 14 were included. The pooled mean difference in DAS28 (95% CI) was 0.34 (0.24,0.44) (p<10-5) between non-drinkers and drinkers, 0.33 (0.05,0.62) (p=0.02) between non-drinkers and heavy drinkers, and 0 (-0.3,0.3) (p=0.98). between low- and high-risk drinkers. There was a significant difference in the mean difference of HAQ assessments between those who drink alcohol compared to those who do not (0.3 (0.18,0.41), p<10-5). There was no significant correlation between drinking and gender, smoking status, or antibody positivity.Conclusion:While it appears that alcohol is linked to remission in inflammatory arthritis, this association is lost when adjusted for gender. Men with inflammatory arthritis drink significantly more than women and men generally have less severe disease activity. However, the meta-analysis suggests alcohol consumption is associated with lower disease activity and self-reported health assessment in rheumatoid arthritis.References:[1]Bae S-C, Lee YH. Alcohol intake and risk of rheumatoid arthritis: a Mendelian randomization study. Z Rheumatol 2019;78:791–6. doi:10.1007/s00393-018-0537-z[2]Scott IC, Tan R, Stahl D, et al. The protective effect of alcohol on developing rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology (Oxford) 2013;52:856–67. doi:10.1093/rheumatology/kes376Figure 1.Mean differences in DAS28 between drinking groups. A between non-drinkers and drinkers. B between non-drinkers and high-risk drinkers. C between low-risk and high-risk drinkers.Disclosure of Interests:None declared


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