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Safety of biologica...
Safety of biological and targeted synthetic disease-modifying antirheumatic drugs for rheumatoid arthritis as used in clinical practice: results from the ARTIS programme
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- Frisell, T. (author)
- Karolinska Institutet,Karolinska Institute
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- Bower, H. (author)
- Karolinska Institutet,Karolinska Institute
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- Morin, M. (author)
- Karolinska Institutet,Karolinska Institute
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- Baecklund, Eva, 1956- (author)
- Uppsala University,Uppsala universitet,Reumatologi
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- Di Giuseppe, D. (author)
- Karolinska Institutet,Karolinska Institute
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- Delcoigne, B. (author)
- Karolinska Institutet,Karolinska Institute
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- Feltelius, Nils (author)
- Uppsala universitet,Allmänmedicin och preventivmedicin
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- Forsblad d'Elia, Helena, 1961 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research,Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Rheumatol & Inflammat Res, Gothenburg, Sweden.,Sahlgrenska Academy
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- Lindqvist, Elisabet (author)
- Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Lund Arthritis Research Group (LARG),Forskargrupper vid Lunds universitet,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups
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- Lindström, Ulf (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,Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Rheumatol & Inflammat Res, Gothenburg, Sweden.,Sahlgrenska Academy
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- Askling, J. (author)
- Karolinska Institutet,Karolinska Institute,Karolinska University Hospital
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(creator_code:org_t)
- 2023-02-14
- 2023
- English.
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In: Annals of the Rheumatic Diseases. - : BMJ. - 0003-4967 .- 1468-2060. ; 82:5
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Abstract
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- ObjectiveLongitudinal clinical registry-infrastructures such as Anti-Rheumatic Therapies in Sweden (ARTIS) allow simultaneous comparison of the safety of individual immunomodulatory drugs used in clinical practice, with consistent definitions of treatment cohorts, follow-up and outcomes. Our objective was to assess and compare incidence rates of key safety outcomes for individual targeted synthetic or biological disease-modifying antirheumatic drugs (b/ts DMARDs) in rheumatoid arthritis (RA), updating previous reports and including newer treatments including Janus Kinase inhibitors (JAKi). MethodsNationwide register-based cohort study including all patients with RA in Sweden registered as starting any b/tsDMARD 1 January 2010 through 31 December 2020, followed until 30 June 2021 (N=20 117). The incidence rates of selected outcomes, identified through national healthcare registers, were compared between individual b/tsDMARDs, adjusted for confounding by demographics, RA disease characteristics and comorbidity. ResultsThere were marked differences in treatment discontinuations due to adverse events (rates per 1000 person-years ranged from 18 on rituximab to 57 on tofacitinib), but few significant differences were observed for the serious adverse events under study. Neither cardiovascular events nor general serious infections were more frequent on baricitinib or tofacitinib versus bDMARDs, but JAKi were associated with higher rates of hospital-treated herpes zoster (HR vs etanercept, 3.82 (95% CI 2.05 to 7.09) and 4.00 (1.59 to 10.06)). Low number of events limited some comparisons, in particular for sarilumab and tofacitinib. ConclusionData from ARTIS supports that the b/tsDMARDs currently used to treat RA have acceptable and largely similar safety profiles, but differences exist in particular concerning tolerability and specific infection risks.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
Keyword
- Antirheumatic Agents
- Biological Therapy
- Arthritis
- Rheumatoid
- Cardiovascular Diseases
- Epidemiology
- serious infections
- etanercept
- risk
- nationwide
- register
- infliximab
- adalimumab
- difference
- survival
- cohort
- Rheumatology
- Antirheumatic Agents
- Arthritis, Rheumatoid
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Frisell, T.
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Bower, H.
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Morin, M.
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Baecklund, Eva, ...
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Di Giuseppe, D.
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Delcoigne, B.
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show more...
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Feltelius, Nils
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Forsblad d'Elia, ...
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Lindqvist, Elisa ...
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Lindström, Ulf
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Askling, J.
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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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Uppsala University
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Lund University
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Karolinska Institutet