Comput Methods Programs Biomed - Infection risk in patients with rheumatoid arthritis treated with etanercept or adalimumab.

Tópicos

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Resumo

JECTIVES: To compare the risk of infection for rheumatoid arthritis (RA) patients who took etanercept or adalimumab medication in a nationwide population.METHODS: RA patients who took etanercept or adalimumab were identified in the Taiwan's National Health Insurance Research Database. The composite outcome of serious infections, including hospitalization for infection, reception of an antimicrobial injection, and tuberculosis were followed for 365 days. A Kaplan-Meier survival curve with a log-rank test and Cox proportional hazards regression were used to compare risks of infection between the two cohorts of tumor necrosis factor (TNF)-a antagonists users. Hazard ratios (HRs) were obtained and adjusted with propensity scores and clinical factors. Sensitivity analyses and subgroup analyses were also performed.RESULTS: In total, 1660 incident etanercept users and 484 incident adalimumab users were eligible for the analysis. The unadjusted HR for infection of the etanercept users was significantly higher than that of the adalimumab users (HR: 1.93; 95% confidence interval (CI): 1.09-3.42; p=0.024). The HRs were 2.04 (95% CI: 1.14-3.65; p=0.016) and 2.02 (95% CI: 1.13-3.61; p=0.018) after adjusting for propensity scores and for propensity scores in addition to clinical factors, respectively. The subgroup analyses revealed that HRs for composite infection was significantly higher in patient subgroups of older age, female, as well as patients who did not have DM, COPD, and hospitalization history at the baseline.CONCLUSION: In this head-to-head cohort study involving a nationwide population of patients with RA, etanercept users demonstrated a higher risk of infection than adalimumab users. Results of this study suggest the possible existence of an intra-class difference in infection risk among TNF-a antagonists.

Resumo Limpo

jectiv compar risk infect rheumatoid arthriti ra patient took etanercept adalimumab medic nationwid populationmethod ra patient took etanercept adalimumab identifi taiwan nation health insur research databas composit outcom serious infect includ hospit infect recept antimicrobi inject tuberculosi follow day kaplanmei surviv curv logrank test cox proport hazard regress use compar risk infect two cohort tumor necrosi factor tnfa antagonist user hazard ratio hrs obtain adjust propens score clinic factor sensit analys subgroup analys also performedresult total incid etanercept user incid adalimumab user elig analysi unadjust hr infect etanercept user signific higher adalimumab user hr confid interv ci p hrs ci p ci p adjust propens score propens score addit clinic factor respect subgroup analys reveal hrs composit infect signific higher patient subgroup older age femal well patient dm copd hospit histori baselineconclus headtohead cohort studi involv nationwid popul patient ra etanercept user demonstr higher risk infect adalimumab user result studi suggest possibl exist intraclass differ infect risk among tnfa antagonist

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