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김서영
김서영 (Seoyoung C Kim) 저자 이메일 보기
Brigham and Women's Hospital
 
조회 591  인쇄하기 주소복사 트위터 공유 페이스북 공유 
Risk of serious infections in tocilizumab versus other biologic drugs in patients with rheumatoid arthritis: a multidatabase cohort study
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Abstract

Objective To investigate the rate of serious bacterial, viral or opportunistic infection in patients with rheumatoid arthritis (RA) starting tocilizumab (TCZ) versus tumour necrosis factor inhibitors (TNFi) or abatacept.

Methods Using claims data from US Medicare from 2010 to 2015, and IMS and MarketScan from 2011 to 2015, we identified adults with RA who initiated TCZ or TNFi (primary comparator)/abatacept (secondary comparator) with prior use of ≥1 different biologic drug or tofacitinib. The primary outcome was hospitalised serious infection (SI), including bacterial, viral or opportunistic infection. To control for >70 confounders, TCZ initiators were propensity score (PS)-matched to TNFi or abatacept initiators. Database-specific HRs were combined by a meta-analysis.

Results The primary cohort included 16 074 TCZ PS-matched to 33 109 TNFi initiators. The risk of composite SI was not different between TCZ and TNFi initiators (combined HR 1.05, 95%?CI 0.95 to 1.16). However, TCZ was associated with an increased risk of serious bacterial infection (HR 1.19, 95%?CI 1.07 to 1.33), skin and soft tissue infections (HR 2.38, 95%?CI 1.47 to 3.86), and diverticulitis (HR 2.34, 95%?CI 1.64 to 3.34) versus TNFi. An increased risk of composite SI, serious bacterial infection, diverticulitis, pneumonia/upper respiratory tract infection and septicaemia/bacteraemia was observed in TCZ versus abatacept users.

Conclusions This large multidatabase cohort study found no difference in composite SI risk in patients with RA initiating TCZ versus TNFi after failing ≥1 biologic drug or tofacitinib. However, the risk of serious bacterial infection, skin and soft tissue infections, and diverticulitis was higher in TCZ versus TNFi initiators. The risk of composite SI was higher in TCZ initiators versus abatacept.

논문정보
- 형식: Research article
- 게재일: 2019년 01월 (BRIC 등록일 2019-01-31)
- 연구진: 국외연구진
- 분야: Medicine
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제2회 오가노이드 심포지엄 및 핸즈온워크샵 [2019 CHA Organoid Center Symposium]
제2회 오가노이드 심포지엄 및 핸즈온워크샵 [2019 CHA Organoid Center Symposium]
날짜: 2019.05.09
장소: 판교 차바이오컴플렉스 국제회의실
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