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Treatment with TNF-blockers and mortality risk in patients with rheumatoid arthritis.

Jacobsson, Lennart LU ; Turesson, Carl LU ; Nilsson, Jan-Åke LU ; Petersson, Ingemar; Lindqvist, Elisabet LU ; Saxne, Tore LU and Geborek, Pierre LU (2007) In Annals of the Rheumatic Diseases 66(5). p.670-675
Abstract
Objective: To assess mortality in patients with rheumatoid arthritis ( RA) treated with tumour necrosis factor (TNF) inhibitors, compared with a standard RA population. Methods: Patients were recruited from a regional register, which includes over 90% of patients with RA treated with TNF blockers in the area in 1999 or later, and a local community-based cohort of patients with RA, established in 1997. Of a total of 1430 patients in the combined cohort,80 years old, 921 received treatment with TNF inhibitors during the study period. The total cohort was linked with the national register for cause of death. Overall mortality in those treated versus those not treated with TNF blockers was estimated using standardised mortality ratios and... (More)
Objective: To assess mortality in patients with rheumatoid arthritis ( RA) treated with tumour necrosis factor (TNF) inhibitors, compared with a standard RA population. Methods: Patients were recruited from a regional register, which includes over 90% of patients with RA treated with TNF blockers in the area in 1999 or later, and a local community-based cohort of patients with RA, established in 1997. Of a total of 1430 patients in the combined cohort,80 years old, 921 received treatment with TNF inhibitors during the study period. The total cohort was linked with the national register for cause of death. Overall mortality in those treated versus those not treated with TNF blockers was estimated using standardised mortality ratios and time-dependent Cox proportional hazards. Results: There were 188 deaths per 7077 person-years at risk in the total cohort. Controlling for age, sex, disability and baseline comorbidity, the adjusted HR for death was 0.65 (95% CI 0.46 to 0.93) in those treated with anti-TNF versus those not treated. The effect was significant in women (HR=0.52, 95% CI 0.33 to 0.82) but not in men (HR=0.95, 95% CI 0.52 to 1.71). Conclusion: After adjusting for disease severity, treatment with TNF inhibitors was found to be associated with a reduced mortality in women but not men with RA. These findings are compatible with a critical role for inflammation in RA-associated premature mortality. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of the Rheumatic Diseases
volume
66
issue
5
pages
670 - 675
publisher
British Medical Association
external identifiers
  • wos:000246018000016
  • scopus:34248185611
ISSN
1468-2060
DOI
10.1136/ard.2006.062497
language
English
LU publication?
yes
id
46cd4583-8e8d-4a0f-acbc-4853b86f8c5f (old id 164083)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17158824&dopt=Abstract
date added to LUP
2007-07-12 11:57:59
date last changed
2017-09-17 07:12:54
@article{46cd4583-8e8d-4a0f-acbc-4853b86f8c5f,
  abstract     = {Objective: To assess mortality in patients with rheumatoid arthritis ( RA) treated with tumour necrosis factor (TNF) inhibitors, compared with a standard RA population. Methods: Patients were recruited from a regional register, which includes over 90% of patients with RA treated with TNF blockers in the area in 1999 or later, and a local community-based cohort of patients with RA, established in 1997. Of a total of 1430 patients in the combined cohort,80 years old, 921 received treatment with TNF inhibitors during the study period. The total cohort was linked with the national register for cause of death. Overall mortality in those treated versus those not treated with TNF blockers was estimated using standardised mortality ratios and time-dependent Cox proportional hazards. Results: There were 188 deaths per 7077 person-years at risk in the total cohort. Controlling for age, sex, disability and baseline comorbidity, the adjusted HR for death was 0.65 (95% CI 0.46 to 0.93) in those treated with anti-TNF versus those not treated. The effect was significant in women (HR=0.52, 95% CI 0.33 to 0.82) but not in men (HR=0.95, 95% CI 0.52 to 1.71). Conclusion: After adjusting for disease severity, treatment with TNF inhibitors was found to be associated with a reduced mortality in women but not men with RA. These findings are compatible with a critical role for inflammation in RA-associated premature mortality.},
  author       = {Jacobsson, Lennart and Turesson, Carl and Nilsson, Jan-Åke and Petersson, Ingemar and Lindqvist, Elisabet and Saxne, Tore and Geborek, Pierre},
  issn         = {1468-2060},
  language     = {eng},
  number       = {5},
  pages        = {670--675},
  publisher    = {British Medical Association},
  series       = {Annals of the Rheumatic Diseases},
  title        = {Treatment with TNF-blockers and mortality risk in patients with rheumatoid arthritis.},
  url          = {http://dx.doi.org/10.1136/ard.2006.062497},
  volume       = {66},
  year         = {2007},
}