OBJECTIVES: Treatment of rheumatoid arthritis (RA) with disease-modifying anti-rheumatic drugs (DMARDs), either synthetic (sDMARDs) or biologic agents (bDMARDs) has significantly improved disease outcome. However, the impact of therapy-related adverse events (AEs), mild, moderate or serious, on disease outcome is under debate. The purpose of the study was to test the hypothesis that AEs, including infections, are rather common in patients receiving bDMARDs than in those receiving sDMARDs. METHODS: Analysis of the medical records of patients followed in a single outpatient clinic was performed. In total, 1403 adults (295 men, 1108 women) were included in the analysis (969 treated with sDMARDs only, 434 with bDMARDs). All AEs and infections were recorded and their severity was graded according to international criteria. Incident rates were calculated and Kaplan-Meier plots as well as Cox proportional-hazards models were performed to examine the association of treatment groups with the risk of any AE. RESULTS: The risk of any AE, irrespective of severity, was significantly higher in patients with bDMARDs with the adjusted hazard ratio being 1.98 (95% CI: 1.64 to 2.39). Patients in the biologic group treated initially with infliximab or adalimumab had a higher risk of AE compared to patients receiving etanercept or other biologic agents. Among patients treated with methotrexate, those receiving a dose below 10 mg had a higher risk of any AE when compared to those receiving higher doses. CONCLUSIONS: The risk of any AE among RA patients treated with bDMARDs was significantly higher compared to those treated with sDMARDs.
OBJECTIVES: Treatment of rheumatoid arthritis (RA) with disease-modifying anti-rheumatic drugs (DMARDs), either synthetic (sDMARDs) or biologic agents (bDMARDs) has significantly improved disease outcome. However, the impact of therapy-related adverse events (AEs), mild, moderate or serious, on disease outcome is under debate. The purpose of the study was to test the hypothesis that AEs, including infections, are rather common in patients receiving bDMARDs than in those receiving sDMARDs. METHODS: Analysis of the medical records of patients followed in a single outpatient clinic was performed. In total, 1403 adults (295 men, 1108 women) were included in the analysis (969 treated with sDMARDs only, 434 with bDMARDs). All AEs and infections were recorded and their severity was graded according to international criteria. Incident rates were calculated and Kaplan-Meier plots as well as Cox proportional-hazards models were performed to examine the association of treatment groups with the risk of any AE. RESULTS: The risk of any AE, irrespective of severity, was significantly higher in patients with bDMARDs with the adjusted hazard ratio being 1.98 (95% CI: 1.64 to 2.39). Patients in the biologic group treated initially with infliximab or adalimumab had a higher risk of AE compared to patients receiving etanercept or other biologic agents. Among patients treated with methotrexate, those receiving a dose below 10 mg had a higher risk of any AE when compared to those receiving higher doses. CONCLUSIONS: The risk of any AE among RApatients treated with bDMARDs was significantly higher compared to those treated with sDMARDs.
Authors: Jean Lucas G da Silva; Daniela F Passos; Viviane M Bernardes; Fernanda L Cabral; Paulo G Schimites; Alessandra G Manzoni; Edilene Gadelha de Oliveira; Cristiane de Bona da Silva; Ruy Carlos Ruver Beck; Matheus H Jantsch; Roberto M Maciel; Daniela B R Leal Journal: Inflammation Date: 2019-10 Impact factor: 4.092
Authors: Roberto Ranza; Maria Celina de la Vega; Ieda Maria Magalhães Laurindo; Marìa Gimena Gómez; David Cezar Titton; Adriana Maria Kakehasi; Alejandro Brigante; Alejandro Benitez; Aline Ranzolin; Amelia Granel; Ana María Cappuccio; Ana Quinteros; André Luiz Shinji Hayata; Andrea Smichowski; Ângela Luzia Branco P Duarte; Barbara Stadler Kahlow; Carolina Sánchez Andia; Claiton Viegas Brenol; Edson Velozo; Eduardo Mussano; Enrique R Soriano; Georges Basile Christopoulos; Geraldo da Rocha Castelar Pinheiro; Gláucio Ricardo Werner de Castro; Gustavo Casado; Hellen Mary da Silveira Carvalho; Ida Elena Exeni; Inês Guimarães da Silveira; Ingrid Petkovic; Ivanio Alves Pereira; Izaias Pereira da Costa; Javier Eduardo Rosa; José Roberto Silva Miranda; Julio Cesar Bertacini de Moraes; Manoel Barros Bertolo; Manuel Buhl; Maria Alícia Lázaro; Maria de Fátima Lobato C da Sauma; Marcelo de Medeiros Pinheiro; Monica Díaz; Mônica Valéria Siqueira Santana de Vechi; Osvaldo Luis Cerda; Pablo Astesana; Pablo Finucci Curi; Paulo Louzada-Jr; Reginaldo Botelho Teodoro; Roberto Acayaba Toledo; Sílvia Papasidero; Valeria Valim; Vander Fernandes; Veronica Saurit; Washington Alves Bianchi; Rogério de Melo Costa Pinto; Miguel Angel Descalzo; Juan Jesus Gomez-Reino Journal: Clin Rheumatol Date: 2019-04-17 Impact factor: 2.980
Authors: Rodrigo N Garcia Salinas; Maria A Lázaro; Santiago Scarafia; Alejandra Cusa; Maria V Martire; Nieves Capozzi; Luciana Casalla; Lucía Zárate; María De la Vega; Maria Correa; Gustavo C Casado; Silvia Papasidero; Silvana Perez; Oscar L Rillo; Damaris Alvarez; Mariana Benegas; María P Girard Bosch; Karin Kirmayr; Ramiro Gomez Journal: Clin Rheumatol Date: 2020-09-28 Impact factor: 2.980
Authors: Heba Farouk Salem; Mohamed Mahmoud Nafady; Rasha Mostafa Kharshoum; Omnia Ahmed Abd El-Ghafar; Hanan Osman Farouk Journal: Int J Nanomedicine Date: 2020-03-06