Sasha Bernatsky1, Christel Renoux, Samy Suissa. 1. Centre for Clinical Epidemiology, Jewish General Hospital-Lady Davis Institute, 3755 Cote Ste-Catherine, Montreal, Quebec, Canada.
Abstract
OBJECTIVE: To estimate the effects of biological drugs on the risk of demyelinating events in rheumatoid arthritis (RA). METHODS: Case-control analyses nested in an administrative database cohort. RESULTS: Initially the risk of demyelinating events appeared to be increased after exposure to anakinra and decreased after exposure to antitumour necrosis factor (anti-TNF) agents. However, this apparent differential risk was due to more anakinra use (and avoidance of anti-TNF agents) in persons at high risk for demyelinating events. In individuals not at high risk, the adjusted rate ratio was 1.31 (95% CI 0.68 to 2.50) after exposure to anti-TNF agents and 0.80 (95% CI 0.29 to 2.24) after exposure to anakinra. CONCLUSIONS: When accounting for differential prescription patterns, there was a trend towards more events after exposure to anti-TNF agents. When studying rare but important potential drug associations, pharmacoepidemiological studies are valuable but must be carefully performed.
OBJECTIVE: To estimate the effects of biological drugs on the risk of demyelinating events in rheumatoid arthritis (RA). METHODS: Case-control analyses nested in an administrative database cohort. RESULTS: Initially the risk of demyelinating events appeared to be increased after exposure to anakinra and decreased after exposure to antitumour necrosis factor (anti-TNF) agents. However, this apparent differential risk was due to more anakinra use (and avoidance of anti-TNF agents) in persons at high risk for demyelinating events. In individuals not at high risk, the adjusted rate ratio was 1.31 (95% CI 0.68 to 2.50) after exposure to anti-TNF agents and 0.80 (95% CI 0.29 to 2.24) after exposure to anakinra. CONCLUSIONS: When accounting for differential prescription patterns, there was a trend towards more events after exposure to anti-TNF agents. When studying rare but important potential drug associations, pharmacoepidemiological studies are valuable but must be carefully performed.
Authors: Sam Horng; Anthony Therattil; Sarah Moyon; Alexandra Gordon; Karla Kim; Azeb Tadesse Argaw; Yuko Hara; John N Mariani; Setsu Sawai; Per Flodby; Edward D Crandall; Zea Borok; Michael V Sofroniew; Candice Chapouly; Gareth R John Journal: J Clin Invest Date: 2017-07-24 Impact factor: 14.808