Risk of Neuroinflammatory Diseases Among New Recipients of Biologic and Targeted Synthetic Disease-Modifying Antirheumatic Drugs

被引:1
|
作者
Casey, Maximilian [1 ]
Pannu, Sonia [2 ]
Bajwa, Saffia [1 ]
Duarte-Garcia, Ali [3 ]
Putman, Michael [1 ]
机构
[1] Med Coll Wisconsin, Milwaukee, WI 53226 USA
[2] Univ Sch Milwaukee, River Hills, WI USA
[3] Mayo Clin, Rochester, MN USA
关键词
DEMYELINIZING NEUROLOGICAL DISEASE; FACTOR-ALPHA THERAPY; RHEUMATOID-ARTHRITIS; MULTIPLE-SCLEROSIS; DEMYELINATING DISEASE; ANTAGONISTS; INFLIXIMAB; INHIBITORS; DATABASE; EVENTS;
D O I
10.1002/acr.25340
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
ObjectiveNeuroinflammatory adverse events have been observed among new users of tumor necrosis factor (TNF) inhibitors. No studies to date have compared the real-world risk of TNFs with other new users of biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs). The objective of this study is to describe the risk of neuroinflammatory disease after initiation b/tsDMARDs.MethodsThis new user comparative effectiveness cohort study used a large US-based electronic health records database to describe the unadjusted incidence of neuroinflammatory adverse events over a 3-year period. The cohort included patients with rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, or ulcerative colitis initiating treatment with a TNF inhibitor (n = 93,661) or other b/tsDMARD (n = 38,354).ResultsAmong 132,015 patients included in the analysis, the most common first biologic agent was a TNF inhibitor; the unadjusted incidence of neuroinflammatory events was numerically lower among new users of TNF inhibitors (incidence 1.34 per 1,000 patient-years) as compared with the combined non-TNF group (1.69 per 1,000 patient-years). There was no significant association between TNF exposure and neuroinflammatory events as compared with the combined non-TNF b/tsDMARDs overall (hazard ratio 1.01; 95% confidence interval 0.75-1.36) and within each disease group.ConclusionThe overall risk of neuroinflammatory events among new users of TNF inhibitors did not differ substantially as compared with new users of other b/tsDMARDs. Meta-analyses of randomized trials should be conducted to corroborate these findings, which may be affected by channeling bias.
引用
收藏
页码:1203 / 1209
页数:7
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