RESEARCH - No evidence of association between anti-TNF biologics and mortality in patients with RA

[Guest guest]

Arthritis Rheum. 2010 Jul 26.

No evidence of association between anti-TNF treatment and mortality in

patients with rheumatoid arthritis: Results from the British Society

for Rheumatology Biologics Register.

Lunt M, KD, Dixon WG, Symmons DP, Hyrich KL; The BSRBR Control

Centre Consortium; on behalf of the BSR Biologics Register.

Arthritis Research UK Epidemiology Unit, Manchester Academic Health

Sciences Centre, The University of Manchester, Manchester, UK.

Abstract

OBJECTIVE:: To study the association between anti-TNF therapy and

mortality in a national cohort of RA patients.

METHODS:: We prospectively followed 12672 patients starting anti-TNF

therapy and 3522 biologic-naive patients receiving DMARDs until

31/07/08 or death, whichever was sooner. Notification and cause of

death were received from the UK national death register. Mortality was

compared using Proportional Hazards. Inverse Probability of

Treatment Weighting (IPTW) was used to adjust for confounding effect

of baseline differences between groups, including age, gender, disease

severity, disability and comorbidity. Missing baseline data were

accounted for using multiple imputation.

RESULTS:: Compared to the DMARD cohort, the anti-TNF patients were

younger (median 57 vs 61 yrs), had higher disease activity (median

DAS28 6.6 vs 5.1) and higher disability (median HAQ 2.1 v 1.6).

Patients in the DMARD cohort were more likely to have a history of

myocardial infarction (4.8 v 3.0%) and chronic obstructive pulmonary

disease (8.1 v 4.8%) but less likely to have had depression (16.5 vs

18.9%). There were 9445 and 50803 person-years of follow-up in the

DMARD and anti-TNF cohorts respectively, during which time 204 DMARD

and 856 anti-TNF patients died. The weighted mortality hazard ratios

in the anti-TNF cohort were: All-cause 0.86 (95% CI 0.64, 1.16),

Circulatory Disease (HR 0.73 (95% CI 0.44, 1.23), Neoplasm (HR 0.65

(95% CI 0.39, 1.09)) and Respiratory Disease (weighted HR 0.81 (95% CI

0.36, 1.83).

CONCLUSIONS:: Compared to patients treated with standard DMARDs, the

addition of anti-TNF therapy was not associated with an increase in

mortality.

PMID: 20662063

http://www.ncbi.nlm.nih.gov/pubmed/20662063

Not an MD

[Guest guest]

That's good to know, .

Sue

On Aug 4, 2010, at 9:30 AM, wrote:

>

> No evidence of association between anti-TNF treatment and mortality in

> patients with rheumatoid arthritis: Results from the British Society

> for Rheumatology Biologics Register.