No increased mortality in patients with rheumatoid arthritis treated with biologics: Results from the biologics register of six rheumatology institutes in Japan

Ayako Nakajima, Kazuyoshi Saito, Toshihisa Kojima, Koichi Amano, Taku Yoshio, Wataru Fukuda, Eisuke Inoue, Atsuo Taniguchi, Shigeki Momohara, Seiji Minota, Tsutomu Takeuchi, Naoki Ishiguro, Yoshiya Tanaka, Hisashi Yamanaka

研究成果: Article

11 引用 (Scopus)

抄録

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.

元の言語English
ページ(範囲)945-952
ページ数8
ジャーナルModern Rheumatology
23
発行部数5
DOI
出版物ステータスPublished - 2013 9

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Rheumatology
Biological Products
Rheumatoid Arthritis
Japan
Mortality
Confidence Intervals
Lung
Lost to Follow-Up
Proportional Hazards Models
Cause of Death
Pneumonia
Adrenal Cortex Hormones
Observation

ASJC Scopus subject areas

  • Rheumatology

これを引用

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.

:: Modern Rheumatology, 巻 23, 番号 5, 09.2013, p. 945-952.

研究成果: Article

Nakajima, A, Saito, K, Kojima, T, Amano, K, Yoshio, T, Fukuda, W, Inoue, E, Taniguchi, A, Momohara, S, Minota, S, Takeuchi, T, Ishiguro, N, Tanaka, Y & Yamanaka, H 2013, 'No increased mortality in patients with rheumatoid arthritis treated with biologics: Results from the biologics register of six rheumatology institutes in Japan', Modern Rheumatology, 巻. 23, 番号 5, pp. 945-952. https://doi.org/10.1007/s10165-012-0773-z
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. / No increased mortality in patients with rheumatoid arthritis treated with biologics : Results from the biologics register of six rheumatology institutes in Japan. :: Modern Rheumatology. 2013 ; 巻 23, 番号 5. pp. 945-952.
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title = "No increased mortality in patients with rheumatoid arthritis treated with biologics: Results from the biologics register of six rheumatology institutes in Japan",
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.",
keywords = "Biologics, Cause of death, Mortality, Rheumatoid arthritis, Standardized mortality ratio",
author = "Ayako Nakajima and Kazuyoshi Saito and Toshihisa Kojima and Koichi Amano and Taku Yoshio and Wataru Fukuda and Eisuke Inoue and Atsuo Taniguchi and Shigeki Momohara and Seiji Minota and Tsutomu Takeuchi and Naoki Ishiguro and Yoshiya Tanaka and Hisashi Yamanaka",
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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

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