Back to Search
Start Over
Comparative Risk of Venous Thromboembolism in Rheumatoid Arthritis Patients Receiving Tofacitinib Versus Those Receiving Tumor Necrosis Factor Inhibitors: An Observational Cohort Study
- Source :
- Arthritis & Rheumatology. 71:892-900
- Publication Year :
- 2019
- Publisher :
- Wiley, 2019.
-
Abstract
- OBJECTIVE To evaluate the risk of venous thromboembolism (VTE) in rheumatoid arthritis (RA) patients receiving tofacitinib versus those receiving tumor necrosis factor (TNF) inhibitors. METHODS RA patients who were initiating treatment with tofacitinib or a TNF inhibitor and had not previously received any biologic agent or tofacitinib were identified from the Truven MarketScan database (2012-2016) or Medicare claims (parts A, B, and D) database (2012-2015). Patients were followed up until treatment discontinuation, treatment switch, insurance disenrollment, or administrative censoring. The outcome of VTE was identified using inpatient claims for pulmonary embolism or deep vein thrombosis. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were determined using a Cox proportional hazards model after accounting for confounding through propensity score-based fine-stratification weighting. HRs were pooled across databases using the inverse variance meta-analytic method. RESULTS A total of 34,074 RA patients (mean age 50 years; 5.6% tofacitinib initiators) and 17,086 RA patients (mean age 71 years; 5.8% tofacitinib initiators) were identified from the Truven and Medicare databases, respectively. The crude incidence rates of VTE per 100 person-years were 0.60 (95% CI 0.26-1.19) and 0.34 (95% CI 0.27-0.41) in Truven and 1.12 (95% CI 0.45-2.31) and 0.92 (95% CI 0.76-1.11) in Medicare for patients receiving tofacitinib and patients receiving TNF inhibitors, respectively. Propensity score-adjusted HRs showed no significant differences in the risk of VTE between tofacitinib-treated and TNF inhibitor-treated patients in either database, with a pooled HR of 1.33 (95% CI 0.78-2.24). CONCLUSION Occurrence of VTE in a total of 50,865 RA patients initiating treatment with tofacitinib or a TNF inhibitor was infrequent (
- Subjects :
- Adult
Male
medicine.medical_specialty
Databases, Factual
medicine.medical_treatment
Immunology
Arthritis, Rheumatoid
Cohort Studies
Piperidines
Rheumatology
Internal medicine
Humans
Janus Kinase Inhibitors
Immunology and Allergy
Medicine
Pyrroles
Aged
Proportional Hazards Models
Venous Thrombosis
Tofacitinib
business.industry
Proportional hazards model
Incidence
Hazard ratio
Venous Thromboembolism
Middle Aged
medicine.disease
Discontinuation
TNF inhibitor
Pyrimidines
Rheumatoid arthritis
Propensity score matching
Female
Tumor Necrosis Factor Inhibitors
Pulmonary Embolism
business
Cohort study
Subjects
Details
- ISSN :
- 23265205 and 23265191
- Volume :
- 71
- Database :
- OpenAIRE
- Journal :
- Arthritis & Rheumatology
- Accession number :
- edsair.doi.dedup.....0e1631d09385e5235ca9677a7ce45fa0
- Full Text :
- https://doi.org/10.1002/art.40798