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. 2018 Jan 5;8(1):e018134.
doi: 10.1136/bmjopen-2017-018134.

Retrospective cohort study on risk of hearing loss in patients with rheumatoid arthritis using claims data

Chung-Ming Huang  1   2 , Hsuan-Ju Chen  3   4 , Po-Hao Huang  1 , Gregory J Tsay  1 , Joung-Liang Lan  1 , Fung-Chang Sung  3   5
Affiliations

Retrospective cohort study on risk of hearing loss in patients with rheumatoid arthritis using claims data

Chung-Ming Huang et al. BMJ Open. .

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.

Keywords: hearing loss; insurance data,; retrospective cohort study; rheumatoid arthritis.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart showing selection of study cohorts. LHID, Longitudinal Health Insurance Database; RA, rheumatoid arthritis.
Figure 2
Figure 2
Kaplan-Meier method estimated cumulative incidence curves of hearing loss in the two cohorts. RA, rheumatoid arthritis.
See this image and copyright information in PMC

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