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Tumour necrosis factor inhibitor exposure and radiographic outcomes in Veterans with rheumatoid arthritis: a longitudinal cohort study.
Cannon, Grant W; Erickson, Alan R; Teng, Chia-Chen; Huynh, Tina; Austin, Sharon; Wade, Sally W; Stolshek, Bradley S; Collier, David H; Mutebi, Alex; Sauer, Brian C.
Afiliación
  • Cannon GW; Salt Lake City VA Medical Center, University of Utah, Salt Lake City, UT, USA.
  • Erickson AR; Division of Rheumatology, University of Utah, Salt Lake City, UT, USA.
  • Teng CC; VA Nebraska-Western Iowa Health Care System and Division of Rheumatology, University of Nebraska Medical Center, Omaha, NE, USA.
  • Huynh T; Salt Lake City VA Medical Center, University of Utah, Salt Lake City, UT, USA.
  • Austin S; Division of Epidemiology, University of Utah, Salt Lake City, UT, USA.
  • Wade SW; Salt Lake City VA Medical Center, University of Utah, Salt Lake City, UT, USA.
  • Stolshek BS; Division of Epidemiology, University of Utah, Salt Lake City, UT, USA.
  • Collier DH; Salt Lake City VA Medical Center, University of Utah, Salt Lake City, UT, USA.
  • Mutebi A; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
  • Sauer BC; Wade Outcomes Research and Consulting, Salt Lake City, UT, USA.
Rheumatol Adv Pract ; 3(1): rkz015, 2019.
Article en En | MEDLINE | ID: mdl-31763619
OBJECTIVES: The aim was to estimate the impact of TNF inhibitor (TNFi) exposure on radiographic disease progression in US Veterans with RA during the first year after initiating therapy. METHODS: This historical longitudinal cohort design used clinical and claims data to evaluate radiographic progression after initiation of TNFi. US Veterans with RA initiating TNFi treatment (index date), ≥ 6 months pre-index and ≥ 12 months post-index VA enrolment/activity, and initial (6 months pre-index to 30 days post-index) and follow-up (10-18 months post-index) bilateral hand radiographs were eligible. The cumulative TNFi exposure and change in modified Sharp score (MSS) between initial and follow-up radiographs were calculated. The percentage of patients with clinically meaningful change in MSS (≥ 5) for each month of exposure was assessed using a longitudinal marginal structural model with inverse probability of treatment weights. Mean values and CIs were generated using 1000 bootstrapped samples. RESULTS: For 246 eligible patients, the mean (s.d.) age was 58 (11) years; 81% were male. The mean (s.d.) initial MSS was 19.6 (33.4) (range 0-214). The mean change (s.d.) in MSS was 0.3 (3.6) (median 0, range -19 to 22). Patients with the greatest exposure had the least radiographic progression for both crude and adjusted model analyses. Adjusted rates of MSS change ≥ 5 points (95% CI) were 10.6% (9.8%, 11.4%) for patients with 3 months of exposure compared with 5.4% (5.1%, 5.7%) for patients with 12 months of exposure. CONCLUSION: One-year changes in radiographic progression were small. Patients with the greatest cumulative TNFi exposure experienced the least progression.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies Idioma: En Revista: Rheumatol Adv Pract Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies Idioma: En Revista: Rheumatol Adv Pract Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido