Paper Info
Title
Infection risk in patients with rheumatoid arthritis treated with etanercept or adalimumab
Abstract
Objectives: 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)[email protected] 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 [email protected] antagonists.
Year
DOI
Venue
2014
10.1016/j.cmpb.2014.06.008
Computer Methods and Programs in Biomedicine
Keywords
Field
DocType
rheumatoid arthritis,adalimumab,tumor necrosis factor-α antagonist,etanercept,infection,tumor necrosis factor-α antagonist
Population,Proportional hazards model,Etanercept,Internal medicine,Adalimumab,Rheumatoid arthritis,Statistics,Surgery,Confidence interval,Cohort study,Medicine,Hazard ratio
Journal
Volume
Issue
ISSN
116
3
1872-7565
Citations 
PageRank 
References 
0
0.34
0
Authors
5
Name
Order
Citations
PageRank
Yi-Chun Chiang1143.29
Li-Na Kuo262.03
Yu-Hsuan Yen320.78
Chao-Hsiun Tang400.34
Hsiang-Yin Chen562.73