Original ArticleTumor necrosis factor-α blockade, cardiovascular outcomes, and survival in rheumatoid arthritis
Section snippets
Study population
We built a cohort of 20,811 U.S. veterans who were diagnosed with RA between October 1998 and September 2005. Patients were included in the cohort if they had an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for RA during the study period and who, after ≥4-month history of receiving medications from the Veterans Administration (VA) during the study period, subsequently received a first prescription of DMARD. Prior experience demonstrates that
Results
The total number of patients who met our diagnostic criteria for RA between October 1998 and September 2005 was 20,811 (75,329 person years). Among those, 19,899 (65,766 person years) individuals received nonbiologic DMARDs and 3796 (9563 person years) individuals received TNF-α antagonists at some time during the study period. The demographic and clinical characteristics of these groups are presented in Table I.
In univariate analyses, the patients treated with TNF-α antagonists were younger
Discussion
In this study, we show that long-term exposure to TNF-α antagonists has no significant effect on combined cardiovascular outcomes or all-cause mortality. Interestingly, we found a decreased risk of cardiovascular events associated with the use of TNF-α antagonists in patients who were younger than 63 years old, and patients treated with TNF-α antagonists had decreased risk of cerebrovascular disease.
The effect of TNF-α blockade on the risk atherosclerotic heart disease, peripheral artery
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2019, Pharmacological ResearchCitation Excerpt :Serious infections and insufficient treatment of cardiovascular diseases were identified as independent drivers of stroke risk in RABBIT [115]. In a cohort of 20811 U.S.A. veterans, treatment with TNFi was not associated with an increased risk of atherosclerotic heart disease, congestive heart failure, or peripheral artery disease, but it was associated with decreased risk of cerebrovascular disease [116]. This is in keeping with data from the BSRBR [117].
Treatment of rheumatoid arthritis with biologic agents lowers the risk of incident chronic kidney disease
2018, Kidney InternationalCitation Excerpt :Information about RA disease activity measures such as the Clinical Disease Activity Index and Disease Activity Score, as well as the erythrocyte sedimentation rate and C-reactive protein values, were not available in this cohort. Instead, we included the number of various RA-related articular procedures as a measure of RA severity, as reported previously.33–36 Finally, as with all observational studies, we cannot eliminate the possibility of unmeasured confounders.
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2018, Revista Colombiana de ReumatologiaReducing cardiovascular risk in immune-mediated inflammatory diseases: Tumour necrosis factor inhibitors compared to conventional therapies—A systematic review and meta-analysis
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Supported by a Department of Veterans Affairs (VISN 15) Career Development Award (to Z. A.A.).