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Risk and case chara...
Risk and case characteristics of tuberculosis in rheumatoid arthritis associated with tumor necrosis factor antagonists in Sweden
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- Askling, Johan (author)
- Karolinska Institutet
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- Fored, C. Michael (author)
- Karolinska Institutet
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- Brandt, Lena (author)
- Karolinska Institutet
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- Baecklund, Eva (author)
- Uppsala universitet,Reumatologi
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Bertilsson, Lennart (author)
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- Cöster, Lars, 1945- (author)
- Östergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Reumatologi,Länskliniken för Reumatologi i Östergötland
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- Geborek, Pierre (author)
- Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Jacobsson, Lennart (author)
- Lund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups
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- Lindblad, Staffan (author)
- Karolinska Institutet
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Lysholm, Jörgen (author)
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- Rantapää-Dahlqvist, Solbritt (author)
- Umeå universitet,Reumatologi
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- Saxne, Tore (author)
- Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine
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Romanus, Victoria (author)
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- Klareskog, Lars (author)
- Karolinska Institutet
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- Feltelius, Nils (author)
- Uppsala universitet,Institutionen för medicinska vetenskaper
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(creator_code:org_t)
- 2005
- 2005
- English.
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In: Arthritis and Rheumatism. - : Wiley. - 0004-3591 .- 1529-0131. ; 52:7, s. 1986-1992
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Abstract
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- OBJECTIVE:Because treatment with tumor necrosis factor (TNF) antagonists may increase the risk of tuberculosis (TB), and because knowledge of the risk of TB in rheumatoid arthritis (RA) not treated with biologics is scarce and of uncertain generalizability to low-risk populations, this study sought to determine the risk of TB among Swedish patients with RA.METHODS:Using data from Swedish nationwide and population-based registers and data from an ongoing monitoring program of TNF antagonists, the relative risks of TB in patients with RA (versus the general population) and of TB associated with TNF antagonists (versus RA patients not treated with biologics) were determined by comparing the incidence of hospitalization for TB in 3 RA cohorts and 2 general population cohorts from 1999 to 2001. We also reviewed the characteristics of all reported cases of TB in RA patients treated with TNF antagonists in Sweden and calculated the incidence of TB per type of TNF antagonist between 1999 and 2004.RESULTS:During 1999-2001, RA patients who were not treated with TNF antagonists were at increased risk of TB versus the general population (relative risk 2.0, 95% confidence interval [95% CI] 1.2-3.4). RA patients treated with TNF antagonists had a 4-fold increased risk of TB (relative risk 4.0, 95% CI 1.3-12) versus RA patients not treated with TNF antagonists. The reported TB cases during 1999-2004 in RA patients exposed to TNF antagonists (9 infliximab, 4 etanercept, 2 both) were predominantly pulmonary. TB occurred up to 3 years following the start of treatment.CONCLUSION:Irrespective of whether TNF antagonists are administered, Swedish patients with RA are at increased risk of TB. During 1999-2001, TNF antagonists were associated with an increased risk of TB, up to 4-fold in magnitude. This increased risk may persist over time during treatment and is related to both infliximab and etanercept.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
Keyword
- Adolescent
- Adult
- Adverse Drug Reaction Reporting Systems
- Aged
- Aged; 80 and over
- Antibodies; Monoclonal/*adverse effects/immunology
- Arthritis; Rheumatoid/*drug therapy/epidemiology/immunology
- Female
- Humans
- Immunosuppression
- Male
- Middle Aged
- Registries
- Research Support; Non-U.S. Gov't
- Risk Factors
- Sweden/epidemiology
- Tuberculosis; Pulmonary/epidemiology/*immunology
- Tumor Necrosis Factor-alpha/*antagonists & inhibitors/immunology
- MEDICINE
- MEDICIN
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Askling, Johan
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Fored, C. Michae ...
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Brandt, Lena
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Baecklund, Eva
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Bertilsson, Lenn ...
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Cöster, Lars, 19 ...
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show more...
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Geborek, Pierre
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Jacobsson, Lenna ...
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Lindblad, Staffa ...
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Lysholm, Jörgen
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Rantapää-Dahlqvi ...
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Saxne, Tore
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Romanus, Victori ...
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Klareskog, Lars
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Feltelius, Nils
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Rheumatology and ...
- Articles in the publication
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Arthritis and Rh ...
- By the university
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Uppsala University
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Umeå University
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Lund University
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Karolinska Institutet
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Linköping University