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Ann Rheum Dis. 2010 Sep;69(9):1691-3. doi: 10.1136/ard.2009.111500. Epub 2009 Jul 23.

Demyelinating events in rheumatoid arthritis after drug exposures.

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  • 1Centre for Clinical Epidemiology, Jewish General Hospital-Lady Davis Institute, 3755 Cote Ste-Catherine, Montreal, Quebec, Canada.

Abstract

OBJECTIVE:

To estimate the effects of biological drugs on the risk of demyelinating events in rheumatoid arthritis (RA).

METHODS:

Case-control analyses nested in an administrative database cohort.

RESULTS:

Initially the risk of demyelinating events appeared to be increased after exposure to anakinra and decreased after exposure to antitumour necrosis factor (anti-TNF) agents. However, this apparent differential risk was due to more anakinra use (and avoidance of anti-TNF agents) in persons at high risk for demyelinating events. In individuals not at high risk, the adjusted rate ratio was 1.31 (95% CI 0.68 to 2.50) after exposure to anti-TNF agents and 0.80 (95% CI 0.29 to 2.24) after exposure to anakinra.

CONCLUSIONS:

When accounting for differential prescription patterns, there was a trend towards more events after exposure to anti-TNF agents. When studying rare but important potential drug associations, pharmacoepidemiological studies are valuable but must be carefully performed.

PMID:
19628820
DOI:
10.1136/ard.2009.111500
[PubMed - indexed for MEDLINE]
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