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

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.

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