دورية أكاديمية
The effect of antimalarials on the safety and persistence of treatment with biologic agents or Janus kinase inhibitors in rheumatoid arthritis.
| العنوان: | The effect of antimalarials on the safety and persistence of treatment with biologic agents or Janus kinase inhibitors in rheumatoid arthritis. |
|---|---|
| المؤلفون: | Bredemeier M; Hospital Nossa Senhora da Conceição, Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil., Duarte ÂL; Hospital das Clinicas da Universidade Federal de Pernambuco, Recife, PE, Brazil., Pinheiro MM; Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, SP, Brazil., Kahlow BS; Hospital Universitário Evangélico Mackenzie, Curitiba, PR, Brazil., Macieira JC; Hospital Universitário da Universidade Federal de Sergipe, Aracajú, SE, Brazil., Ranza R; Hospital das Clínicas da Universidade Federal de Uberlândia, Uberlândia, MG, Brazil., Miranda JR; Artrocenter Clínica Médica, Taubaté, SP, Brazil., Valim V; Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo, Vitória, ES, Brazil., de Castro GR; Hospital Governador Celso Ramos, Florianópolis, SC, Brazil., Bértolo MB; Hospital das Clínicas da Universidade Estadual de Campinas, Campinas, SP, Brazil., Sauma MF; Universidade Federal do Pará, Belém, PA, Brazil., Fernandes V; Hospital Geral de Cuiabá, Cuiabá, MT, Brazil., Ribeiro AC; Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil., Teodoro RB; Hospital de Clínicas da Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil., Brenol CV; Universidade Federal do Rio Grande do Sul/Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil., Carvalho HM; Hospital de Base do Distrito Federal, Brasília, DF, Brazil., Studart SA; Hospital Geral de Fortaleza, Fortaleza, CE, Brazil., Pinheiro GR; Universidade Estadual do Rio de Janeiro/Hospital Universitário Pedro Ernesto, Rio de Janeiro, RJ, Brazil., da Rocha LF Jr; Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brazil., de Lima HD; Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brazil., Pereira IA; Hospital Universitário da Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil., Gazzeta MO; Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil., Kakehasi AM; Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil., Louzada P Jr; Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil., Hayata AL; Clínica de Reumatologia, Osasco, SP, Brazil., Lupo CM; Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil., da Silveira IG; Faculdade de Medicina da Pontifícia Universidade Católica do Rio Grande do Sul/Hospital São Lucas, Porto Alegre, RS, Brazil., Kowalski SC; Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, PR, Brazil., Titton DC; Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, PR, Brazil., Chakr RM; Universidade Federal do Rio Grande do Sul/Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil., Ranzolin A; Hospital das Clinicas da Universidade Federal de Pernambuco, Recife, PE, Brazil., Xavier RM; Universidade Federal do Rio Grande do Sul/Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil., Laurindo IM; Faculdade de Medicina da Universidade Nove de Julho, São Paulo, SP, Brazil. |
| المصدر: | Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2024 Feb 01; Vol. 63 (2), pp. 456-465. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 100883501 Publication Model: Print Cited Medium: Internet ISSN: 1462-0332 (Electronic) Linking ISSN: 14620324 NLM ISO Abbreviation: Rheumatology (Oxford) Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Oxford, UK : Avenel, N.J. : Oxford University Press ; Distributed by Mercury International, c1999- |
| مواضيع طبية MeSH: | Janus Kinase Inhibitors*/adverse effects , Antimalarials*/adverse effects , Arthritis, Rheumatoid*/epidemiology , Antirheumatic Agents*/adverse effects , Biological Products*/therapeutic use, Humans ; Cohort Studies |
| مستخلص: | Objectives: To test the association of use of antimalarials with the overall safety of treatment in RA patients receiving one or multiple courses of biologic (b)DMARDs or a Janus kinase inhibitor (JAKi). Methods: BiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients with rheumatic diseases starting their first bDMARD or JAKi. The present analysis includes RA patients recruited from January 2009 to October 2019, followed up over one or multiple (up to six) courses of treatment (latest date, 19 November 2019). The primary outcome was the incidence of serious adverse events (SAEs). Total and system-specific adverse events (AEs) and treatment interruption served as secondary outcomes. Negative binomial regression with generalized estimating equations (to estimate multivariate incidence rate ratios, mIRR) and frailty Cox proportional hazards models were used for statistical analyses. Results: The number of patients enrolled was 1316 (2335 treatment courses, 6711 patient-years [PY]; 1254.5 PY on antimalarials). The overall incidence of SAEs was 9.2/100 PY. Antimalarials were associated with reduced risk of SAEs (mIRR: 0.49; 95% CI: 0.36, 0.68; P < 0.001), total AEs (0.68; 95% CI: 0.56, 0.81; P < 0.001), serious infections (0.53; 95% CI: 0.34, 0.84; P = 0.007) and total hepatic AEs (0.21; 95% CI: 0.05, 0.85; P = 0.028). Antimalarials were also related to better survival of treatment course (P = 0.003). There was no significant increase in the risk of cardiovascular AEs. Conclusion: Among RA patients on treatment with bDMARDs or JAKi, concomitant use of antimalarials was associated with reduced the incidence of serious and total AEs and with longer treatment course survival. (© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.) |
| معلومات مُعتمدة: | Brazilian Society of Rheumatology |
| فهرسة مساهمة: | Keywords: JAK inhibitors; RA; adverse events; antimalarials; biologics; hydroxychloroquine; safety |
| المشرفين على المادة: | 0 (Janus Kinase Inhibitors) 0 (Antimalarials) 0 (Antirheumatic Agents) 0 (Biological Products) |
| تواريخ الأحداث: | Date Created: 20230522 Date Completed: 20240205 Latest Revision: 20240205 |
| رمز التحديث: | 20240205 |
| DOI: | 10.1093/rheumatology/kead232 |
| PMID: | 37216912 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1462-0332 |
|---|---|
| DOI: | 10.1093/rheumatology/kead232 |