Centre for Primary Care and Health Services Research Seminar – Dr Sara Muller – ‘Antibiotic use and rheumatoid arthritis: a case-control study in the CPRD’
| Dates: | 20 October 2020 |
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| Times: | 13:00 - 14:00 |
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| What is it: | Seminar |
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| Organiser: | Faculty of Biology, Medicine and Health |
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| Who is it for: | University staff, Current University students |
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| Speaker: | Dr Sara Muller |
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Background: Antibiotic-induced disturbances of the human microbiota have been implicated in the development of chronic autoimmune conditions. We aimed to assess whether antibiotic use is associated with the onset of rheumatoid arthritis (RA).
Methods: We conducted a case-control study in the CPRD. Patients with an incident diagnosis of RA were identified (1995-2017). Each case was matched on age, gender, and general practice to up to 5 controls without RA. Conditional logistic regression was used to examine previous antibiotic, anti-viral and anti-fungal prescriptions and RA onset after controlling for confounding factors.
Results: We identified 22,677 cases of RA, matched to 90,013 controls, with a median record length of 10 years before RA diagnosis. The odds of developing RA were 60% higher in those exposed to antibiotics than in those not exposed (OR 1.60; 95% CI 1.51-1.68). A dose- or frequency-dependent association was observed between the number of previous antibiotic prescriptions and RA. All classes of antibiotics were associated with higher odds of RA, with bactericidal antibiotics carrying higher risk than bacteriostatic (45% vs. 31%). Those with antibiotic-treated upper respiratory tract (URT) infections were more likely to be RA cases. However, this was not observed for URT infections not treated with antibiotics. Antifungal (OR = 1.27; 95% CI 1.20-1.35) and antiviral (OR = 1.19; 95% CI 1.14-1.24) prescriptions were also associated with increased odds of RA.
Conclusion: Antibiotic prescriptions are associated with a higher risk of RA. This may be due to microbiota disturbances or underlying infections driving risk.
Dr Sara Muller will discuss the motivation for this work and some of the methodological issues it raised, including the definition of RA and the potential for protopathic bias.
For Zoom details, please email: CPC.seminar.series@manchester.ac.uk
Speaker
Dr Sara Muller
Role: Senior Lecturer in Epidemiology & Applied Statistics
Organisation: Keele University
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