Exposure to specific tumour necrosis factor inhibitors and risk of demyelinating and inflammatory neuropathy in cohorts of patients with inflammatory arthritis: a collaborative observational study across five Nordic rheumatology registers
OBJECTIVE: To compare incidences of neuroinflammatory events, including demyelinating disease (DML), inflammatory polyneuropathies (IPN) and multiple sclerosis (MS), in patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA; including psoriatic arthritis) starting a tumour necrosis factor...
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Online Access: | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980369/ http://www.ncbi.nlm.nih.gov/pubmed/36854568 https://doi.org/10.1136/rmdopen-2022-002924 |
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ftpubmed:oai:pubmedcentral.nih.gov:9980369 2023-05-15T16:01:19+02:00 Exposure to specific tumour necrosis factor inhibitors and risk of demyelinating and inflammatory neuropathy in cohorts of patients with inflammatory arthritis: a collaborative observational study across five Nordic rheumatology registers Delcoigne, Benedicte Kopp, Tine Iskov Arkema, Elizabeth V Hellgren, Karin Provan, Sella Aarrestad Relas, Heikki Aaltonen, Kalle Trokovic, Nina Gudbjornsson, Bjorn Grondal, Gerdur Klami Kristianslund, Eirik Lindhardsen, Jesper Dreyer, Lene Askling, Johan 2023-02-28 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980369/ http://www.ncbi.nlm.nih.gov/pubmed/36854568 https://doi.org/10.1136/rmdopen-2022-002924 en eng BMJ Publishing Group http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980369/ http://www.ncbi.nlm.nih.gov/pubmed/36854568 http://dx.doi.org/10.1136/rmdopen-2022-002924 © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . CC-BY-NC RMD Open Epidemiology Text 2023 ftpubmed https://doi.org/10.1136/rmdopen-2022-002924 2023-03-05T02:52:49Z OBJECTIVE: To compare incidences of neuroinflammatory events, including demyelinating disease (DML), inflammatory polyneuropathies (IPN) and multiple sclerosis (MS), in patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA; including psoriatic arthritis) starting a tumour necrosis factor inhibitor (TNFi), investigating whether monoclonal TNFi antibodies (other TNFis (oTNFis)) confer higher risk than etanercept. METHODS: This is an observational cohort study including patients from the five Nordic countries starting a TNFi in 2001–2020. Time to first neuroinflammatory event was identified through register linkages. We calculated crude incidence rates (cIR) per 1000 person-years and used multivariable-adjusted Cox regression to compare incidences of neuroinflammatory events overall and for DML, IPN and MS with oTNFi versus etanercept. We further examined individual TNFis and indications. RESULTS: 33 883 patients with RA and 28 772 patients with SpA were included, initiating 52 704 and 46 572 treatment courses, respectively. In RA, we observed 135 neuroinflammatory events (65% DML) with cIR of 0.38 with oTNFi and 0.34 with etanercept. The HR of oTNFi versus etanercept was 1.07 (95% CI 0.74 to 1.54) for any neuroinflammatory event, 0.79 (95% CI 0.51 to 1.22) for DML, 2.20 (95% CI 1.05 to 4.63) for IPN and 0.73 (95% CI 0.34 to 1.56) for MS. In SpA, we observed 179 events (78% DML) with cIR of 0.68 with oTNFi and 0.65 with etanercept. The HR for any neuroinflammatory event, DML, IPN and MS was 1.06 (95% CI 0.75 to 1.50), 1.01 (95% CI 0.68 to 1.50), 1.28 (95% CI 0.61 to 2.69) and 0.94 (95% CI0.53 to 1.69), respectively. CONCLUSION: The cIRs of neuroinflammatory events are higher in SpA than in RA, but the choice of specific TNFi does not seem to play an important role in the risk of neuroinflammatory events. Text DML PubMed Central (PMC) RMD Open 9 1 e002924 |
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Epidemiology |
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Epidemiology Delcoigne, Benedicte Kopp, Tine Iskov Arkema, Elizabeth V Hellgren, Karin Provan, Sella Aarrestad Relas, Heikki Aaltonen, Kalle Trokovic, Nina Gudbjornsson, Bjorn Grondal, Gerdur Klami Kristianslund, Eirik Lindhardsen, Jesper Dreyer, Lene Askling, Johan Exposure to specific tumour necrosis factor inhibitors and risk of demyelinating and inflammatory neuropathy in cohorts of patients with inflammatory arthritis: a collaborative observational study across five Nordic rheumatology registers |
topic_facet |
Epidemiology |
description |
OBJECTIVE: To compare incidences of neuroinflammatory events, including demyelinating disease (DML), inflammatory polyneuropathies (IPN) and multiple sclerosis (MS), in patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA; including psoriatic arthritis) starting a tumour necrosis factor inhibitor (TNFi), investigating whether monoclonal TNFi antibodies (other TNFis (oTNFis)) confer higher risk than etanercept. METHODS: This is an observational cohort study including patients from the five Nordic countries starting a TNFi in 2001–2020. Time to first neuroinflammatory event was identified through register linkages. We calculated crude incidence rates (cIR) per 1000 person-years and used multivariable-adjusted Cox regression to compare incidences of neuroinflammatory events overall and for DML, IPN and MS with oTNFi versus etanercept. We further examined individual TNFis and indications. RESULTS: 33 883 patients with RA and 28 772 patients with SpA were included, initiating 52 704 and 46 572 treatment courses, respectively. In RA, we observed 135 neuroinflammatory events (65% DML) with cIR of 0.38 with oTNFi and 0.34 with etanercept. The HR of oTNFi versus etanercept was 1.07 (95% CI 0.74 to 1.54) for any neuroinflammatory event, 0.79 (95% CI 0.51 to 1.22) for DML, 2.20 (95% CI 1.05 to 4.63) for IPN and 0.73 (95% CI 0.34 to 1.56) for MS. In SpA, we observed 179 events (78% DML) with cIR of 0.68 with oTNFi and 0.65 with etanercept. The HR for any neuroinflammatory event, DML, IPN and MS was 1.06 (95% CI 0.75 to 1.50), 1.01 (95% CI 0.68 to 1.50), 1.28 (95% CI 0.61 to 2.69) and 0.94 (95% CI0.53 to 1.69), respectively. CONCLUSION: The cIRs of neuroinflammatory events are higher in SpA than in RA, but the choice of specific TNFi does not seem to play an important role in the risk of neuroinflammatory events. |
format |
Text |
author |
Delcoigne, Benedicte Kopp, Tine Iskov Arkema, Elizabeth V Hellgren, Karin Provan, Sella Aarrestad Relas, Heikki Aaltonen, Kalle Trokovic, Nina Gudbjornsson, Bjorn Grondal, Gerdur Klami Kristianslund, Eirik Lindhardsen, Jesper Dreyer, Lene Askling, Johan |
author_facet |
Delcoigne, Benedicte Kopp, Tine Iskov Arkema, Elizabeth V Hellgren, Karin Provan, Sella Aarrestad Relas, Heikki Aaltonen, Kalle Trokovic, Nina Gudbjornsson, Bjorn Grondal, Gerdur Klami Kristianslund, Eirik Lindhardsen, Jesper Dreyer, Lene Askling, Johan |
author_sort |
Delcoigne, Benedicte |
title |
Exposure to specific tumour necrosis factor inhibitors and risk of demyelinating and inflammatory neuropathy in cohorts of patients with inflammatory arthritis: a collaborative observational study across five Nordic rheumatology registers |
title_short |
Exposure to specific tumour necrosis factor inhibitors and risk of demyelinating and inflammatory neuropathy in cohorts of patients with inflammatory arthritis: a collaborative observational study across five Nordic rheumatology registers |
title_full |
Exposure to specific tumour necrosis factor inhibitors and risk of demyelinating and inflammatory neuropathy in cohorts of patients with inflammatory arthritis: a collaborative observational study across five Nordic rheumatology registers |
title_fullStr |
Exposure to specific tumour necrosis factor inhibitors and risk of demyelinating and inflammatory neuropathy in cohorts of patients with inflammatory arthritis: a collaborative observational study across five Nordic rheumatology registers |
title_full_unstemmed |
Exposure to specific tumour necrosis factor inhibitors and risk of demyelinating and inflammatory neuropathy in cohorts of patients with inflammatory arthritis: a collaborative observational study across five Nordic rheumatology registers |
title_sort |
exposure to specific tumour necrosis factor inhibitors and risk of demyelinating and inflammatory neuropathy in cohorts of patients with inflammatory arthritis: a collaborative observational study across five nordic rheumatology registers |
publisher |
BMJ Publishing Group |
publishDate |
2023 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980369/ http://www.ncbi.nlm.nih.gov/pubmed/36854568 https://doi.org/10.1136/rmdopen-2022-002924 |
genre |
DML |
genre_facet |
DML |
op_source |
RMD Open |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980369/ http://www.ncbi.nlm.nih.gov/pubmed/36854568 http://dx.doi.org/10.1136/rmdopen-2022-002924 |
op_rights |
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
op_rightsnorm |
CC-BY-NC |
op_doi |
https://doi.org/10.1136/rmdopen-2022-002924 |
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RMD Open |
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