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Response to biologi...
Response to biological treatment and subsequent risk of coronary events in rheumatoid arthritis
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- Ljung, Lotta (author)
- Umeå universitet,Umeå University,Karolinska Institutet,Reumatologi,Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
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- Rantapää-Dahlqvist, Solbritt (author)
- Umeå universitet,Umeå University,Reumatologi
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- Jacobsson, Lennart T. H., 1954 (author)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research
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- Askling, J. (author)
- Karolinska Institutet
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- Klareskog, Lars (author)
- Karolinska Institutet
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- van Vollenhoven, Ronald (author)
- Karolinska Institutet
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- Baecklund, Eva (author)
- Uppsala University
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- Kastbom, Alf (author)
- Linköping University
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- Turesson, Carl (author)
- Lund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups
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Lindqvist, Elisabeth (author)
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- Forsblad-d'Elia, Helena (author)
- Umeå University
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- Feltelius, Nils (author)
- Swedish medical products agency
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Ernestam, Sofia (author)
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(creator_code:org_t)
- 2016-03-16
- 2016
- English.
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In: Annals of the Rheumatic Diseases. - : BMJ. - 0003-4967 .- 1468-2060. ; 75:12, s. 2087-2094
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Abstract
Subject headings
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- Objectives Whether the increased risk of comorbidities, such as cardiovascular disease, in rheumatoid arthritis (RA) can be reverted by particular antirheumatic therapies, or response to these, is unclear but of critical clinical importance. We wanted to investigate whether response to tumour necrosis factor inhibitors (TNFi) translates into a reduced risk for acute coronary syndrome (ACS). Methods A cohort of patients with RA initiating a first TNFi 2001-2012 was identified in the Swedish Biologics Register. The association between European League Against Rheumatism (EULAR) response after 3-8 months of treatment (assessed using the first, the best and the measurement closest to 5 months, respectively), and the risk of incident ACS during the subsequent year was analysed in Cox regression models. Adjustments included cardiovascular risk factors, joint surgery, RA duration, education and work disability. Results During 6592 person-years among TNFi initiators (n=6864, mean age 55 years, 77% women), 47 ACS occurred. The adjusted HRs (95% CI), which were similar to the crude HRs, of the 1-year risk of ACS among EULAR good responders compared with non-responders were 0.5 (0.2 to 1.4), 0.4 (0.2 to 0.9) and 0.5 (0.2 to 1.2), for the first, the best and the evaluation closest to 5 months, respectively. EULAR moderate responders had equal risk to that of EULAR non-responders, who, compared with the general population referents (n=34 229), had a more than twice the risk of ACS. For good responders, there was no statistically significant difference in risk versus the general population. Conclusions Optimised RA disease control has the potential to revert otherwise increased risks for ACS in RA.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
Keyword
- disease-activity index
- acute myocardial-infarction
- necrosis-factor
- inhibitors
- cardiovascular events
- controlled-trial
- british-society
- alpha therapy
- register
- ra
- validation
- Rheumatology
- evoo mll
- 1995
- arthritis and rheumatism
- v38
- p44
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Ljung, Lotta
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Rantapää-Dahlqvi ...
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Jacobsson, Lenna ...
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Askling, J.
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Klareskog, Lars
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van Vollenhoven, ...
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show more...
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Baecklund, Eva
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Kastbom, Alf
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Turesson, Carl
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Lindqvist, Elisa ...
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Forsblad-d'Elia, ...
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Feltelius, Nils
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Ernestam, Sofia
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- 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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and Rheumatology and ...
- Articles in the publication
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Annals of the Rh ...
- By the university
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University of Gothenburg
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Lund University
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Umeå University
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Karolinska Institutet