Risk of serious infection associated with different classes of targeted therapies used in psoriatic arthritis: a nationwide cohort study from the French Health Insurance Database (SNDS)
Objective To assess the risk of serious infection associated with different targeted therapies for psoriatic arthritis (PsA) in real-world settings.Methods This nationwide cohort study used the administrative healthcare database of the French health insurance scheme linked to the hospital discharge...
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BMJ Publishing Group
2024-02-01
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| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/10/1/e003865.full |
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| author | Pascal Claudepierre Léa Bastard Laura Pina Vegas Emilie Sbidian Laetitia Penso |
| author_facet | Pascal Claudepierre Léa Bastard Laura Pina Vegas Emilie Sbidian Laetitia Penso |
| author_sort | Pascal Claudepierre |
| collection | DOAJ |
| description | Objective To assess the risk of serious infection associated with different targeted therapies for psoriatic arthritis (PsA) in real-world settings.Methods This nationwide cohort study used the administrative healthcare database of the French health insurance scheme linked to the hospital discharge database to identify all adults with PsA who were new users of targeted therapies (adalimumab, etanercept, golimumab, certolizumab pegol, infliximab, secukinumab, ixekizumab, ustekinumab, and tofacitinib) from 1 January 2015 to 30 June 2021. The primary outcome was a serious infection (ie, requiring hospitalisation), in a time-to-event analysis using propensity score-weighted Cox models, with adalimumab as the comparator, estimating weighted HRs (wHRs) and their 95% CIs.Results A total of 12 071 patients were included (mean age 48.7±12.7 years; 6965 (57.7%) women). We identified 367 serious infections (3.0% of patients), with a crude incidence rate of 17.0 per 1000 person-years (95% CI, 15.2 to 18.7). After inverse propensity score weighting and adjustment for time-dependent covariates and calendar year, risk of serious infection was significantly lower for new users of etanercept (wHR 0.72; 95% CI, 0.53 to 0.97) or ustekinumab (wHR, 0.57; 95% CI, 0.35 to 0.93) than adalimumab new users. This risk was not statistically modified with the other targeted therapies.Conclusions The incidence of serious infection was low for PsA patients who were new users of targeted therapies in real-world settings. Relative to adalimumab new users, this risk was lower among new users of etanercept and ustekinumab and unmodified for the other molecules. |
| format | Article |
| id | doaj-art-45755af8a64a4699b066f730f68c4f13 |
| institution | DOAJ |
| issn | 2056-5933 |
| language | English |
| publishDate | 2024-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | RMD Open |
| spelling | doaj-art-45755af8a64a4699b066f730f68c4f132025-08-20T03:11:53ZengBMJ Publishing GroupRMD Open2056-59332024-02-0110110.1136/rmdopen-2023-003865Risk of serious infection associated with different classes of targeted therapies used in psoriatic arthritis: a nationwide cohort study from the French Health Insurance Database (SNDS)Pascal Claudepierre0Léa Bastard1Laura Pina Vegas2Emilie Sbidian3Laetitia Penso4Rheumatology, Hospital Henri Mondor, Créteil, FranceEpidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE), University Paris-Est Créteil Val de Marne, Créteil, FranceRheumatology, Hospital Henri Mondor, Créteil, FranceInserm, Centre d’investigation clinique 1430, Hôpital Henri Mondor, Créteil, Île-de-France, FranceEpidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE), University Paris-Est Créteil Val de Marne, Créteil, FranceObjective To assess the risk of serious infection associated with different targeted therapies for psoriatic arthritis (PsA) in real-world settings.Methods This nationwide cohort study used the administrative healthcare database of the French health insurance scheme linked to the hospital discharge database to identify all adults with PsA who were new users of targeted therapies (adalimumab, etanercept, golimumab, certolizumab pegol, infliximab, secukinumab, ixekizumab, ustekinumab, and tofacitinib) from 1 January 2015 to 30 June 2021. The primary outcome was a serious infection (ie, requiring hospitalisation), in a time-to-event analysis using propensity score-weighted Cox models, with adalimumab as the comparator, estimating weighted HRs (wHRs) and their 95% CIs.Results A total of 12 071 patients were included (mean age 48.7±12.7 years; 6965 (57.7%) women). We identified 367 serious infections (3.0% of patients), with a crude incidence rate of 17.0 per 1000 person-years (95% CI, 15.2 to 18.7). After inverse propensity score weighting and adjustment for time-dependent covariates and calendar year, risk of serious infection was significantly lower for new users of etanercept (wHR 0.72; 95% CI, 0.53 to 0.97) or ustekinumab (wHR, 0.57; 95% CI, 0.35 to 0.93) than adalimumab new users. This risk was not statistically modified with the other targeted therapies.Conclusions The incidence of serious infection was low for PsA patients who were new users of targeted therapies in real-world settings. Relative to adalimumab new users, this risk was lower among new users of etanercept and ustekinumab and unmodified for the other molecules.https://rmdopen.bmj.com/content/10/1/e003865.full |
| spellingShingle | Pascal Claudepierre Léa Bastard Laura Pina Vegas Emilie Sbidian Laetitia Penso Risk of serious infection associated with different classes of targeted therapies used in psoriatic arthritis: a nationwide cohort study from the French Health Insurance Database (SNDS) RMD Open |
| title | Risk of serious infection associated with different classes of targeted therapies used in psoriatic arthritis: a nationwide cohort study from the French Health Insurance Database (SNDS) |
| title_full | Risk of serious infection associated with different classes of targeted therapies used in psoriatic arthritis: a nationwide cohort study from the French Health Insurance Database (SNDS) |
| title_fullStr | Risk of serious infection associated with different classes of targeted therapies used in psoriatic arthritis: a nationwide cohort study from the French Health Insurance Database (SNDS) |
| title_full_unstemmed | Risk of serious infection associated with different classes of targeted therapies used in psoriatic arthritis: a nationwide cohort study from the French Health Insurance Database (SNDS) |
| title_short | Risk of serious infection associated with different classes of targeted therapies used in psoriatic arthritis: a nationwide cohort study from the French Health Insurance Database (SNDS) |
| title_sort | risk of serious infection associated with different classes of targeted therapies used in psoriatic arthritis a nationwide cohort study from the french health insurance database snds |
| url | https://rmdopen.bmj.com/content/10/1/e003865.full |
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