• RA patients show significantly increased SSNHL risk. • Large-scale nationwide cohort strengthens validity. • Propensity matching reduces confounding bias. • RA increases SSNHL risk by approximately 2.7-fold. • Consistent findings across stratified and sensitivity analyses. To determine whether Rheumatoid Arthritis (RA) is associated with an increased risk of incident Sudden Sensorineural Hearing Loss (SSNHL). The authors conducted a nationwide, propensity-score-matched cohort study using Taiwan’s Longitudinal Health Insurance Database (2000–2015). Adults with incident RA (n = 45,425) were matched 1:4 to those without RA controls (n = 181,700). The primary outcome was incident SSNHL (ICD-9-CM 389.10). Time-to-event analyses used Kaplan-Meier curves with log-rank tests and multivariable Cox regression. Landmark sensitivity analyses excluded SSNHL events within the first 1- and, separately, 5-years of follow-up. SSNHL occurred in 169/45,425 (0.37%) RA patients and 462/181,700 (0.25%) controls. RA was associated with a higher SSNHL risk (adjusted hazard ratio 2.695, 95% CI 2.248–3.231; p < 0.001). Kaplan-Meier and log-rank tests showed greater cumulative incidence in the RA cohort (p < 0.001). In landmark sensitivity analyses excluding events within the first 1- and 5-years, the association remained significant (Year 1: 34 vs. 45, p = 0.007; Year 5: 105 vs. 172, p < 0.001), indicating that the excess risk was not driven by very early events. The present study revealed a high frequency of SSNHL in patients with RA, which highlights the importance of heightened clinical vigilance and prompt audiologic evaluation for hearing-related symptoms in this population.
Chen et al. (Thu,) studied this question.