Comparative safety of infliximab and etanercept on the risk of serious infections: does the association vary by patient characteristics?
Identifieur interne : 001411 ( Main/Exploration ); précédent : 001410; suivant : 001412Comparative safety of infliximab and etanercept on the risk of serious infections: does the association vary by patient characteristics?
Auteurs : Sengwee Toh [États-Unis] ; Lingling Li [États-Unis] ; Leslie R. Harrold [États-Unis] ; Elizabeth A. Bayliss [États-Unis] ; Jeffrey R. Curtis [États-Unis] ; Liyan Liu [États-Unis] ; Lang Chen [États-Unis] ; Carlos G. Grijalva [États-Unis] ; Lisa J. Herrinton [États-Unis]Source :
- Pharmacoepidemiology and Drug Safety [ 1053-8569 ] ; 2012-05.
English descriptors
- Teeft :
- Ankylosing spondylitis, Arthritis, Arthritis rheum, Asian american african american, Autoimmune diseases, Baseline, Baseline period, Body mass index, Census block, Charlson comorbidity score, Clin epidemiol, Confounders, Copyright, Crude incidence rate, Differential risk, Drug safety, Etanercept, Etanercept initiators, Hazard ratio, Hazard ratios, Higher risk, Incidence rate, Incidence rates, Index date, Infection, Initiator, John wiley sons, Kaiser permanente, Kpnc, Likelihood ratio test, Medication, Methotrexate, Necrosis, Necrosis factor therapy, Nonsmoker, Number outpatient visits, Observational studies, Opportunistic infections, Outpatient, Past smokers, Patient characteristics, Permanente, Pharmacoepidemiology, Potential confounders, Poverty line, Propensity, Propensity score, Propensity score model, Psoriatic arthritis, Pulmonary disease, Quartile, Referent, Relative risk, Rheum, Rheumatoid, Rheumatoid arthritis, Rheumatoid arthritis patients, Serious infection, Serious infections, Serious infections table, Smoker, Smoking, Smoking information, Smoking status, Smoking status nonsmoker, Study patients, Study population, Treatment initiation, Tumor necrosis factor, Unique medications.
Abstract
Purpose: Infliximab, a chimeric monoclonal anti‐TNFα antibody, has been found to increase the risk of serious infections compared with the TNF receptor fusion protein etanercept in some studies. It is unclear whether the risk varies by patient characteristics. We conducted a study to address this question. Methods: We identified members of Kaiser Permanente Northern California who initiated infliximab (n = 793) or etanercept (n = 2692) in 1997–2007. Using a Cox model, we estimated the propensity‐score‐adjusted hazard ratio (HR) and 95% confidence interval (CI) of serious infections requiring hospitalization or opportunistic infections comparing infliximab initiators to etanercept initiators. We tested whether the adjusted HR differed by age, sex, race/ethnicity, body mass index, and smoking status. Results: The crude incidence rate of serious infections per 100 person‐years was 5.4 (95%CI: 3.8, 7.5) in patients <65 years and 16.0 (95%CI: 10.4, 23.4) in patients ≥65 years during the first 3 months following treatment initiation. Compared with etanercept, the adjusted HR during this period was elevated for infliximab in patients <65 years (HR: 3.01; 95%CI: 1.49, 6.07), but not in those ≥65 years (HR 0.94; 95%CI: 0.41, 2.13). Findings did not suggest that the HR varied by the other patient characteristics examined. Conclusions: An increased risk of serious infections associated with infliximab relative to etanercept did not appear to be modified by patients' sex, race/ethnicity, body mass index, or smoking status. There was an indication that the increased risk might be limited to patients <65 years. Additional studies are warranted to verify or refute this finding. Copyright © 2012 John Wiley & Sons, Ltd.
Url:
DOI: 10.1002/pds.3238
Affiliations:
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Herrinton</name><affiliation wicri:level="1"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Research, Kaiser Permanente Northern California, CA, Oakland</wicri:regionArea><wicri:noRegion>Oakland</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Pharmacoepidemiology and Drug Safety</title><title level="j" type="alt">PHARMACOEPIDEMIOLOGY AND DRUG SAFETY</title><idno type="ISSN">1053-8569</idno><idno type="eISSN">1099-1557</idno><imprint><biblScope unit="vol">21</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="524">524</biblScope><biblScope unit="page" to="534">534</biblScope><biblScope unit="page-count">11</biblScope><publisher>John Wiley & Sons, Ltd</publisher><pubPlace>Chichester, UK</pubPlace><date type="published" when="2012-05">2012-05</date></imprint><idno type="ISSN">1053-8569</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1053-8569</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Ankylosing spondylitis</term><term>Arthritis</term><term>Arthritis rheum</term><term>Asian american african american</term><term>Autoimmune diseases</term><term>Baseline</term><term>Baseline period</term><term>Body mass index</term><term>Census block</term><term>Charlson comorbidity score</term><term>Clin epidemiol</term><term>Confounders</term><term>Copyright</term><term>Crude incidence rate</term><term>Differential risk</term><term>Drug safety</term><term>Etanercept</term><term>Etanercept initiators</term><term>Hazard ratio</term><term>Hazard ratios</term><term>Higher risk</term><term>Incidence rate</term><term>Incidence rates</term><term>Index date</term><term>Infection</term><term>Initiator</term><term>John wiley sons</term><term>Kaiser permanente</term><term>Kpnc</term><term>Likelihood ratio test</term><term>Medication</term><term>Methotrexate</term><term>Necrosis</term><term>Necrosis factor therapy</term><term>Nonsmoker</term><term>Number outpatient visits</term><term>Observational studies</term><term>Opportunistic infections</term><term>Outpatient</term><term>Past smokers</term><term>Patient characteristics</term><term>Permanente</term><term>Pharmacoepidemiology</term><term>Potential confounders</term><term>Poverty line</term><term>Propensity</term><term>Propensity score</term><term>Propensity score model</term><term>Psoriatic arthritis</term><term>Pulmonary disease</term><term>Quartile</term><term>Referent</term><term>Relative risk</term><term>Rheum</term><term>Rheumatoid</term><term>Rheumatoid arthritis</term><term>Rheumatoid arthritis patients</term><term>Serious infection</term><term>Serious infections</term><term>Serious infections table</term><term>Smoker</term><term>Smoking</term><term>Smoking information</term><term>Smoking status</term><term>Smoking status nonsmoker</term><term>Study patients</term><term>Study population</term><term>Treatment initiation</term><term>Tumor necrosis factor</term><term>Unique medications</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract">Purpose: Infliximab, a chimeric monoclonal anti‐TNFα antibody, has been found to increase the risk of serious infections compared with the TNF receptor fusion protein etanercept in some studies. It is unclear whether the risk varies by patient characteristics. We conducted a study to address this question. Methods: We identified members of Kaiser Permanente Northern California who initiated infliximab (n = 793) or etanercept (n = 2692) in 1997–2007. Using a Cox model, we estimated the propensity‐score‐adjusted hazard ratio (HR) and 95% confidence interval (CI) of serious infections requiring hospitalization or opportunistic infections comparing infliximab initiators to etanercept initiators. We tested whether the adjusted HR differed by age, sex, race/ethnicity, body mass index, and smoking status. Results: The crude incidence rate of serious infections per 100 person‐years was 5.4 (95%CI: 3.8, 7.5) in patients <65 years and 16.0 (95%CI: 10.4, 23.4) in patients ≥65 years during the first 3 months following treatment initiation. Compared with etanercept, the adjusted HR during this period was elevated for infliximab in patients <65 years (HR: 3.01; 95%CI: 1.49, 6.07), but not in those ≥65 years (HR 0.94; 95%CI: 0.41, 2.13). Findings did not suggest that the HR varied by the other patient characteristics examined. Conclusions: An increased risk of serious infections associated with infliximab relative to etanercept did not appear to be modified by patients' sex, race/ethnicity, body mass index, or smoking status. There was an indication that the increased risk might be limited to patients <65 years. Additional studies are warranted to verify or refute this finding. Copyright © 2012 John Wiley & Sons, Ltd.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Angleterre</li><li>Colorado</li><li>Massachusetts</li><li>Midlands de l'Ouest</li></region><settlement><li>Birmingham</li><li>Boston</li></settlement></list><tree><country name="États-Unis"><region name="Massachusetts"><name sortKey="Toh, Sengwee" sort="Toh, Sengwee" uniqKey="Toh S" first="Sengwee" last="Toh">Sengwee Toh</name></region><name sortKey="Bayliss, Elizabeth A" sort="Bayliss, Elizabeth A" uniqKey="Bayliss E" first="Elizabeth A." last="Bayliss">Elizabeth A. Bayliss</name><name sortKey="Bayliss, Elizabeth A" sort="Bayliss, Elizabeth A" uniqKey="Bayliss E" first="Elizabeth A." last="Bayliss">Elizabeth A. Bayliss</name><name sortKey="Chen, Lang" sort="Chen, Lang" uniqKey="Chen L" first="Lang" last="Chen">Lang Chen</name><name sortKey="Curtis, Jeffrey R" sort="Curtis, Jeffrey R" uniqKey="Curtis J" first="Jeffrey R." last="Curtis">Jeffrey R. Curtis</name><name sortKey="Grijalva, Carlos G" sort="Grijalva, Carlos G" uniqKey="Grijalva C" first="Carlos G." last="Grijalva">Carlos G. Grijalva</name><name sortKey="Harrold, Leslie R" sort="Harrold, Leslie R" uniqKey="Harrold L" first="Leslie R." last="Harrold">Leslie R. Harrold</name><name sortKey="Herrinton, Lisa J" sort="Herrinton, Lisa J" uniqKey="Herrinton L" first="Lisa J." last="Herrinton">Lisa J. Herrinton</name><name sortKey="Li, Lingling" sort="Li, Lingling" uniqKey="Li L" first="Lingling" last="Li">Lingling Li</name><name sortKey="Liu, Liyan" sort="Liu, Liyan" uniqKey="Liu L" first="Liyan" last="Liu">Liyan Liu</name><name sortKey="Toh, Sengwee" sort="Toh, Sengwee" uniqKey="Toh S" first="Sengwee" last="Toh">Sengwee Toh</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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