Coronavirus Live Count Map India
remove_red_eye 2985 Views
COVID-19 Vaccine Updates
Coronavirus Protocols
#Multispeciality
.jpg)
950: HCQS in diabetes
In 2014, hydroxychloroquine 400 mg got DCGI approval as additional indication as an adjunct to diet and exercise to improve glycemic control of patients on metformin, sulfonylurea combination in type 2 diabetes.
Then why it cannot be given as a routine in all patients with metabolic syndrome with COVID evidence?
Among patients with rheumatoid arthritis (RA) or psoriasis, use of anti-inflammatory, disease-modifying antirheumatic drugs, such as TNF inhibitors and hydroxychloroquine, is associated with a lower incidence of diabetes than other agents.
[Solomon DH, et al. Association between disease-modifying antirheumatic drugs and diabetes risk in patients with rheumatoid arthritis and psoriasis. JAMA. 2011;305(24):2525-31.]
Rheumatoid arthritis and psoriasis have been linked with insulin resistance and diabetes mellitus (DM). Evidence suggests that systemic immunosuppressive drugs could possibly improve insulin resistance and reduce the risk of DM.
Solomon and colleagues conducted a study to comapre the risk of newly recorded DM among individuals diagnosed with RA or psoriasis based on use of a variety of disease-modifying antirheumatic drugs (DMARDs).
This was a retrospective cohort study involving 121,280 patients with a diagnosis of either RA or psoriasis on at least 2 visits. The mean follow-up was 5.8 months and started with the first prescription for a DMARD after study eligibility was met. Drug regimens were categorized as follows: (1) tumor necrosis factor (TNF) inhibitors with or without other DMARDs; (2) methotrexate without TNF inhibitors or hydroxychloroquine; (3) hydroxychloroquine without TNF inhibitors or methotrexate; or (4) other nonbiologic DMARDs without TNF inhibitors, methotrexate, or hydroxychloroquine (reference exposure).
Newly recorded DM as noted by a new diagnosis of DM with use of a DM-specific medication was assessed.
The study cohort included 13,905 participants with 22,493 treatment episodes starting 1 of the categories of DMARD regimens. New diabetes cases and respective incidence rates per 1000 person-years were reported as: other nonbiologic DMARDs - 55 cases among 3993 treatment episodes; rate, 50.2; TNF inhibitors - 80 cases among 4623 treatment episodes; rate, 19.7; methotrexate - 82 cases among 8195 treatment episodes; rate, 23.8; and hydroxychloroquine - 50 cases among 5682 treatment episodes; rate, 22.2.
The multivariate adjusted hazard ratios for DM were estimated as 0.62 (95% CI, 0.42-0.91) for TNF inhibitors, 0.77 (95% CI, 0.53-1.13) for methotrexate, and 0.54 (95% CI, 0.36-0.80) for hydroxychloroquine, compared with other nonbiologic DMARDS.
Investigators concluded that among patients with RA or psoriasis, the adjusted risk of DM appeared to be lower for those initiating a TNF inhibitor or hydroxychloroquine compared with initiation of other nonbiologic DMARDs.
Division of Pharmacoepidemiology, Department of Medicine, Brigham and Womens Hospital, Boston, Massachusetts 02115, USA. dsolomon@partners.org
Dr KK Aggarwal
President CMAAO
To comment on this article,
create a free account.
Already registered?
.jpg)
Good morning.patients with covid 19 infection have propensity for infectious viral carditis after being infected with highly virulent syrains of corona birus infection pandemic year 2020.hydroxy chloroquine in patients with DM ENSURES GOOD CONTROL OF DIABEYES IN DIABETIC PATIENTS AS IS USEFUL BOTH AS MAINSTAY THERAPY WITH OTHER ORAL HYPOGLYCAEMIC ORAL MEFICAL TOONS ALONG WITH INSULIN BOTH LENTE AND SEMILENTE INSULIN ALSO FOR TREATMENT OF D.M PATIENTS. IN PATIENTS OF COVID INFECTION PANDEMIC YEAR 2020 ,COVID 19 INFECTION PATIENTS DEVELOP AND HAVE PROPENSITY TO DEVELOP INFECTIPUS CARDITIS ,GIVING HYDROXYCHLOROQUINE WILL AGGREVATE AND RESULT IN XARDIAC COMPLICATION CARDITIS WHICH REQUIRES PROMPT STOPPING OF HYDROXY CHLOROQUONE AND ICU TREATMENT OF PATIENTS FOR CARDITIS ALSO WITH VENTILATORY SUPPORT PROMPTLY AS A EMERGENCY WITH CONTINUOUS CARFIORESPIRATORATORY MONITORING . HYDROXY CHLOROQUINESHOULD BE GIVEN ONLY TO TJISE COVID 19 INFECTION PATIENTS WITH MALARIA AND ECG,DOPPLER,2D EC