RESEARCH - Influence of anti-TNF therapy on mortality in patients with RA-associated ILD

[Guest guest]

Ann Rheum Dis. 2010 May 5. [Epub ahead of print]

Influence of anti-TNF therapy on mortality in patients with rheumatoid

arthritis-associated interstitial lung disease: results from the

British Society for Rheumatology Biologics Register.

Dixon WG, Hyrich KL, KD, Lunt M; BSRBR Control Centre

Consortium, Symmons DP; on behalf of the British Society for

Rheumatology Biologics Register.

1Arthritis Research UK Epidemiology Unit, Manchester Academic Health

Sciences Centre, University of Manchester, Manchester, UK.

Abstract

BACKGROUND: Anti-tumour necrosis factor (anti-TNF) therapy has been

associated with reports of rapid severe progression of rheumatoid

arthritis-associated interstitial lung disease (RA-ILD). However,

reports also exist of favourable responses to anti-TNF therapy in

patients with ILD. The aim of this study was to examine the influence

of anti-TNF therapy on mortality in patients with pre-existing RA-ILD.

METHODS: Using data from the British Society for Rheumatology

Biologics Register, a national prospective observational study, 367

patients with pre-existing RA-ILD were identified (299 treated with

anti-TNF therapy and 68 treated with traditional disease-modifying

antirheumatic drugs (DMARDs)).

RESULTS: 70/299 patients (23%) in the anti-TNF cohort died after a

median follow-up of 3.8 years compared with 14/68 (21%) in the DMARD

cohort after a median follow-up of 2.1 years. The mortality was 68

deaths/1000 person years (pyrs) (95% CI 53 to 86) in the anti-TNF

cohort and 92/1000 pyrs (95% CI 50 to 155) in the DMARD cohort,

generating an age- and sex-adjusted mortality rate ratio (aMRR) of

1.26 (95% CI 0.69 to 2.31). After further adjustment for potential

confounders, the aMRR fell to 0.81 (95% CI 0.38 to 1.73) for the

anti-TNF cohort compared with the DMARD cohort. RA-ILD was the

underlying cause of death in 15/70 (21%) and 1/14 (7%) patients in the

anti-TNF and DMARD cohorts, respectively.

CONCLUSION: The mortality in patients with RA-ILD is not increased

following treatment with anti-TNF therapy compared with traditional

DMARDs. The proportion of deaths attributable to RA-ILD is higher in

patients treated with anti-TNF therapy, although reporting bias may

exist.

PMID: 20444754

http://www.ncbi.nlm.nih.gov/pubmed/20444754

Not an MD

[Guest guest]

, I noticed you do lots of reading and reporting.  I appreciate that.  I

am curious though as to any medical training you have had.  Would you mind

telling me that?

VonneB

 

From: <Rheumatoid.Arthritis.Support@...>

Subject: [ ] RESEARCH - Influence of anti-TNF therapy on mortality in

patients with RA-associated ILD

" " < >

Date: Wednesday, May 12, 2010, 10:00 PM

 

Ann Rheum Dis. 2010 May 5. [Epub ahead of print]

Influence of anti-TNF therapy on mortality in patients with rheumatoid

arthritis-associated interstitial lung disease: results from the

British Society for Rheumatology Biologics Register.

Dixon WG, Hyrich KL, KD, Lunt M; BSRBR Control Centre

Consortium, Symmons DP; on behalf of the British Society for

Rheumatology Biologics Register.

1Arthritis Research UK Epidemiology Unit, Manchester Academic Health

Sciences Centre, University of Manchester, Manchester, UK.

Abstract

BACKGROUND: Anti-tumour necrosis factor (anti-TNF) therapy has been

associated with reports of rapid severe progression of rheumatoid

arthritis-associated interstitial lung disease (RA-ILD). However,

reports also exist of favourable responses to anti-TNF therapy in

patients with ILD. The aim of this study was to examine the influence

of anti-TNF therapy on mortality in patients with pre-existing RA-ILD.

METHODS: Using data from the British Society for Rheumatology

Biologics Register, a national prospective observational study, 367

patients with pre-existing RA-ILD were identified (299 treated with

anti-TNF therapy and 68 treated with traditional disease-modifying

antirheumatic drugs (DMARDs)).

RESULTS: 70/299 patients (23%) in the anti-TNF cohort died after a

median follow-up of 3.8 years compared with 14/68 (21%) in the DMARD

cohort after a median follow-up of 2.1 years. The mortality was 68

deaths/1000 person years (pyrs) (95% CI 53 to 86) in the anti-TNF

cohort and 92/1000 pyrs (95% CI 50 to 155) in the DMARD cohort,

generating an age- and sex-adjusted mortality rate ratio (aMRR) of

1.26 (95% CI 0.69 to 2.31). After further adjustment for potential

confounders, the aMRR fell to 0.81 (95% CI 0.38 to 1.73) for the

anti-TNF cohort compared with the DMARD cohort. RA-ILD was the

underlying cause of death in 15/70 (21%) and 1/14 (7%) patients in the

anti-TNF and DMARD cohorts, respectively.

CONCLUSION: The mortality in patients with RA-ILD is not increased

following treatment with anti-TNF therapy compared with traditional

DMARDs. The proportion of deaths attributable to RA-ILD is higher in

patients treated with anti-TNF therapy, although reporting bias may

exist.

PMID: 20444754

http://www.ncbi.nlm.nih.gov/pubmed/20444754

Not an MD

[Guest guest]

Hi, Vonne. I have no formal medical training.

As moderator of the group, I post research and other information which

I think might be interesting or helpful to our members.

Not an MD

On Wed, May 12, 2010 at 10:03 PM, yvonne K <vonneb22000@...> wrote:

>

> , I noticed you do lots of reading and reporting.  I appreciate that.  I

am curious though as to any medical training you have had.  Would you mind

telling me that?

>

> VonneB