RESEARCH has shown that long-term use of antibiotics is associated with a higher risk of rheumatoid arthritis (RA).
Certain studies suggest a potential link between antibiotic use and the development of RA, but the relationship remains unclear. This study aimed to investigate whether prolonged antibiotic use increases the risk of RA, using a large population-based cohort to provide additional epidemiological evidence.
Researchers conducted a retrospective cohort analysis involving adults aged 40 years or older, using data from the Korean National Health Insurance Service. Antibiotic exposure was measured between 2003 and 2007, and participants were followed from January 1, 2008, to December 31, 2019. The study evaluated the risk of developing RA based on the cumulative days of antibiotic use and the number of antibiotic classes taken, employing multivariable Cox hazard regression models to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Sensitivity analyses were conducted to ensure the robustness of the findings.
Over the follow-up period, which spanned 3,395,590 person-years, 29,274 new cases of RA were identified. The analysis revealed that participants who used antibiotics for 91 or more days had a significantly higher risk of RA (aHR 1.79, 95% CI 1.67–1.92) compared to non-users. Similarly, individuals who used four or more antibiotic classes had an increased risk of RA (aHR 1.61, 95% CI 1.51–1.71). The risk was positively correlated with both a higher cumulative antibiotic exposure and a greater number of drug classes used. These trends persisted in sensitivity analyses, confirming the robustness of the findings.
In conclusion, this study provides evidence of a potential association between long-term antibiotic use and an increased risk of developing RA. While further research is essential to fully understand the underlying mechanisms, clinicians should be mindful of the risks when prescribing long-term antibiotic treatments, particularly for patients at higher risk of RA.
Katrina Thornber, EMJ
Reference
Park SJ et al. Association between antibiotics use and the risk of rheumatoid arthritis: a retrospective cohort study in South Korea. Rheumatology (Oxford). 2024;DOI:10.1093/rheumatology/keae483.
