Abstract
Objective: To investigate the influence of biologics on mortality and risk factors for death in rheumatoid arthritis (RA) patients. Methods: RA patients treated with at least one dose of biologics in daily practice in six large rheumatology institutes ("biologics cohort") were observed until 15 May 2010 or death, whichever occurred first. Mortality of the biologics cohort and the "comparator cohort" (comprising patients among the IORRA cohort who had never been treated with biologics) was compared to that of the Japanese general population. Factors associated with mortality were assessed by a Cox model. Results: Among 2683 patients with 6913.0 patient-years of observation, 38 deaths were identified in the biologics cohort. The probability of death in patients lost to follow-up, calculated using the weighted standardized mortality ratio (SMR), was 1.08 [95 % confidence interval (CI) 0.77-1.47] in the biologics cohort and 1.28 (95 % CI 1.17-1.41) in the comparator cohort. Pulmonary involvement was the main cause of death (47.4 %), and the disease-specific SMR of pneumonia was 4.19 (95 % CI 1.81-8.25). Risk factors for death included male gender [hazard ratio (HR) 2.78 (95 % CI 1.24-6.22)], advanced age (HR 1.07, 95 % CI 1.03-1.11), and corticosteroid dose (HR 1.08, 95 % CI 1.01-1.17). Conclusion: Mortality in RA patients exposed to biologics did not exceed that in patients not exposed to biologics, but death from pulmonary manifestations was proportionally increased in RA patients exposed to biologics.
| Original language | English |
|---|---|
| Pages (from-to) | 945-952 |
| Number of pages | 8 |
| Journal | Modern Rheumatology |
| Volume | 23 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2013 Sep |
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Keywords
- Biologics
- Cause of death
- Mortality
- Rheumatoid arthritis
- Standardized mortality ratio
ASJC Scopus subject areas
- Rheumatology
Cite this
No increased mortality in patients with rheumatoid arthritis treated with biologics : Results from the biologics register of six rheumatology institutes in Japan. / Nakajima, Ayako; Saito, Kazuyoshi; Kojima, Toshihisa; Amano, Koichi; Yoshio, Taku; Fukuda, Wataru; Inoue, Eisuke; Taniguchi, Atsuo; Momohara, Shigeki; Minota, Seiji; Takeuchi, Tsutomu; Ishiguro, Naoki; Tanaka, Yoshiya; Yamanaka, Hisashi.
In: Modern Rheumatology, Vol. 23, No. 5, 09.2013, p. 945-952.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - No increased mortality in patients with rheumatoid arthritis treated with biologics
T2 - Results from the biologics register of six rheumatology institutes in Japan
AU - Nakajima, Ayako
AU - Saito, Kazuyoshi
AU - Kojima, Toshihisa
AU - Amano, Koichi
AU - Yoshio, Taku
AU - Fukuda, Wataru
AU - Inoue, Eisuke
AU - Taniguchi, Atsuo
AU - Momohara, Shigeki
AU - Minota, Seiji
AU - Takeuchi, Tsutomu
AU - Ishiguro, Naoki
AU - Tanaka, Yoshiya
AU - Yamanaka, Hisashi
PY - 2013/9
Y1 - 2013/9
N2 - Objective: To investigate the influence of biologics on mortality and risk factors for death in rheumatoid arthritis (RA) patients. Methods: RA patients treated with at least one dose of biologics in daily practice in six large rheumatology institutes ("biologics cohort") were observed until 15 May 2010 or death, whichever occurred first. Mortality of the biologics cohort and the "comparator cohort" (comprising patients among the IORRA cohort who had never been treated with biologics) was compared to that of the Japanese general population. Factors associated with mortality were assessed by a Cox model. Results: Among 2683 patients with 6913.0 patient-years of observation, 38 deaths were identified in the biologics cohort. The probability of death in patients lost to follow-up, calculated using the weighted standardized mortality ratio (SMR), was 1.08 [95 % confidence interval (CI) 0.77-1.47] in the biologics cohort and 1.28 (95 % CI 1.17-1.41) in the comparator cohort. Pulmonary involvement was the main cause of death (47.4 %), and the disease-specific SMR of pneumonia was 4.19 (95 % CI 1.81-8.25). Risk factors for death included male gender [hazard ratio (HR) 2.78 (95 % CI 1.24-6.22)], advanced age (HR 1.07, 95 % CI 1.03-1.11), and corticosteroid dose (HR 1.08, 95 % CI 1.01-1.17). Conclusion: Mortality in RA patients exposed to biologics did not exceed that in patients not exposed to biologics, but death from pulmonary manifestations was proportionally increased in RA patients exposed to biologics.
AB - Objective: To investigate the influence of biologics on mortality and risk factors for death in rheumatoid arthritis (RA) patients. Methods: RA patients treated with at least one dose of biologics in daily practice in six large rheumatology institutes ("biologics cohort") were observed until 15 May 2010 or death, whichever occurred first. Mortality of the biologics cohort and the "comparator cohort" (comprising patients among the IORRA cohort who had never been treated with biologics) was compared to that of the Japanese general population. Factors associated with mortality were assessed by a Cox model. Results: Among 2683 patients with 6913.0 patient-years of observation, 38 deaths were identified in the biologics cohort. The probability of death in patients lost to follow-up, calculated using the weighted standardized mortality ratio (SMR), was 1.08 [95 % confidence interval (CI) 0.77-1.47] in the biologics cohort and 1.28 (95 % CI 1.17-1.41) in the comparator cohort. Pulmonary involvement was the main cause of death (47.4 %), and the disease-specific SMR of pneumonia was 4.19 (95 % CI 1.81-8.25). Risk factors for death included male gender [hazard ratio (HR) 2.78 (95 % CI 1.24-6.22)], advanced age (HR 1.07, 95 % CI 1.03-1.11), and corticosteroid dose (HR 1.08, 95 % CI 1.01-1.17). Conclusion: Mortality in RA patients exposed to biologics did not exceed that in patients not exposed to biologics, but death from pulmonary manifestations was proportionally increased in RA patients exposed to biologics.
KW - Biologics
KW - Cause of death
KW - Mortality
KW - Rheumatoid arthritis
KW - Standardized mortality ratio
UR - http://www.scopus.com/inward/record.url?scp=84885171585&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84885171585&partnerID=8YFLogxK
U2 - 10.1007/s10165-012-0773-z
DO - 10.1007/s10165-012-0773-z
M3 - Article
VL - 23
SP - 945
EP - 952
JO - Modern Rheumatology
JF - Modern Rheumatology
SN - 1439-7595
IS - 5
ER -