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Objective: Preclinical studies suggest that thiazolidinediones (TZDs) may have a protective effect on rheumatoid arthritis (RA), but evidence from population‐based studies is scarce. This study aimed to assess the association between use of TZDs and incidence of RA in a retrospective cohort of patients with type 2 diabetes mellitus (T2DM). Methods: A retrospective cohort of patients with T2DM who were new users of TZDs or alpha glucosidase inhibitors (AGIs) was assembled. We applied the inverse probability of treatment weighted Cox model to estimate the hazard ratio (HR) of RA incidence associated with the use of TZDs compared with AGIs. Results: The final analysis included 56,796 new users of AGIs and 14,892 new users of TZDs. The incidence of RA was 187.4 and 135.2 per 100,000 person‐years in AGI users and TZD users, respectively. Compared with use of AGIs, TZD use was associated with a reduction in RA incidence, with an HR of 0.72 (95% confidence interval [95% CI] 0.59–0.89). HRs for cumulative use of TZDs for 0.51 to 4.0 years and more than 4 years with incidence of RA were 0.55 (95% CI 0.35–0.88) and 0.74 (95% CI 0.57–0.98), respectively. Various subgroup analyses and sensitivity analyses were consistent with the primary analysis. Conclusion: Use of TZDs is associated with a decreased risk of incident RA in patients with T2DM. [ABSTRACT FROM AUTHOR]

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2 a An incident dementia case was defined as (a) having at least two consecutive diagnosis code or description of F00-F03 or G30, or (b) having at least one dementia diagnosis record and prescription records of antidementia drugs. Similarly, TZD use was consistently associated with dementia risk in terms of history of mental disorders, with an HR of 0.53 (95% CI, 0.30-0.94) and 0.50 (95% CI, 0.36-0.69) for T2DM patients with and without history of any mental disorders, respectively. We thank Wasif et al for their comments[1] on our article that explored the association between thiazolidinedione (TZD) use and dementia risk in patients with type 2 diabetes mellitus (T2DM).[2] In their letter, the authors addressed the potential confounding effects of age of diabetes onset and mental disorders, which were suggested to be associated with dementia risk in recent studies,[[3]] and thus they suggested subgroup analyses according to participants' age at T2DM onset and status of mental disorders.[1] In our analyses we controlled age and years of T2DM at baseline[2]; thus the issue of collinearity would arise in the multivariate and inverse probability weighted model if we controlled age of T2DM onset, which was the difference between baseline age and diabetes duration. [Extracted from the article]