Risk of hospitalized infections in older elderly patients with rheumatoid arthritis treated with tocilizumab or other biological/targeted synthetic disease-modifying antirheumatic drugs: Evaluation of data from a Japanese claims database
Risk of hospitalized infections in older elderly patients with rheumatoid arthritis treated with tocilizumab or other biological/targeted synthetic disease-modifying antirheumatic drugs: Evaluation of data from a Japanese claims database
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使用托珠单抗或其他生物/靶向合成缓解病情抗风湿药物治疗的老年类风湿性关节炎患者住院感染的风险：对日本理赔数据库数据的评估
DOI：
10.1093/mr/road031
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发表时间：
2023
影响因子：
2.2
通讯作者：
Kawahito Yutaka
中科院分区：
文献类型：
--
作者：
Harigai Masayoshi;Fujii Takao;Sakai Ryoko;Igarashi Ataru;Shoji Ayako;Yamaguchi Hiroko;Iwasaki Katsuhiko;Makishima Misako;Yoshida Amika;Okada Norihiro;Yamashita Katsuhisa;Kawahito Yutaka
目的比较托西珠单抗(tocilizumab，TCZ)和其他生物/靶向抗风湿药物(b/tsDMARDS)在75岁的类风湿关节炎(≥ ，RA)患者中的住院感染(HIS)发生率。方法使用日本东京医疗数据视觉株式会社的日本索赔数据库，对2014年至2019年期间服用b/tsDMARDS的RA患者进行回顾性的人群纵向研究。结果5 506例患者中，2 2 65例(41 1%)为65 岁，1 709例(31 0%)为65~74岁，1 532例(2 7 8%)为≥75岁。HIS粗发病率(/100人年)分别为3.99、7.27和10.77。在年龄最大的组中，His(b/tsDMARDS与TCZ)的ARR(95%可信区间)如下：依那西普，2.40(1.24-4.61)；阿达莫单抗，1.90(0.75-4.83)；Golimumab，1.21(0.66-2.23)；abatacept，0.89(0.49-1.62)。在其他年龄组中，最年轻组的依那西普的ARR较低(0.30，0.11~0.85)。结论在年龄为75 的RA患者中，除依那西普外，b/tsDMARDS发生HIS的风险与他西单抗相似。
ObjectiveWe compared the incidence rates of hospitalized infections (HIs) between tocilizumab (TCZ) and other biological/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in adults aged ≥75 years with rheumatoid arthritis (RA).MethodsWe used a Japanese claims database from Medical Data Vision Co., Ltd (Tokyo, Japan) to perform a retrospective longitudinal population-based study in patients with RA who were prescribed b/tsDMARDs between 2014 and 2019. We calculated adjusted risk ratios (aRRs) for HIs in three age groups (<65, ≥65 and <75, and ≥75 years).ResultsOf 5506 patients, 2265 (41.1%) were <65 years, 1709 (31.0%) were 65–74 years, and 1532 (27.8%) were ≥75 years. Crude incidence rates (/100 person-years) of HIs were 3.99, 7.27, and 10.77, respectively. In the oldest group, aRRs (95% confidence interval) for HIs (b/tsDMARDs versus TCZ) were as follows: etanercept, 2.40 (1.24–4.61); adalimumab, 1.90 (0.75–4.83); golimumab, 1.21 (0.66–2.23); and abatacept, 0.89 (0.49–1.62). In the other age groups, the noticeable difference was a lower aRR of etanercept versus TCZ in the youngest group (0.30, 0.11–0.85).ConclusionIn patients with RA aged ≥75 years, b/tsDMARDs have a similar risk of HIs to tocilizumab except for etanercept.