RESEARCH - Demyelinating events in RA after drug exposures

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Ann Rheum Dis. 2009 Jul 23.

Demyelinating events in rheumatoid arthritis after drug exposures.

Bernatsky S, Renoux C, Suissa S.

Research Institute of the McGill University Health Centre, Canada.

OBJECTIVE: To estimate biologic drug effects on risk of demyelinating

events in rheumatoid arthritis (RA).

METHODS: Case-control analyses, nested in an administrative database cohort.

RESULTS: Initially, risk of demyelinating events appeared increased

after anakinra drug exposure, and decreased after 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 after anti-TNF exposures was 1.31 (95% CI 0.68, 2.50) and

after anakinra, 0.80 (0.29, 2.24).

CONCLUSIONS: When accounting for differential prescription patterns,

we noted a trend towards more events after anti-TNF exposures. When

studying rare but important potential drug associations,

pharmacoepidemiologic studies are valuable but must be carefully-done.

PMID: 19628820

http://www.ncbi.nlm.nih.gov/pubmed/19628820

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