Spondyloarthritis & psoriatic arthritis
Antimicrobial Use and Serious Infections Among Patients With Psoriatic Arthritis After Initiating Tumor Necrosis Factor Inhibitors: A Nationwide Matched Cohort Study
An erratum to this article was published (J Rheumatol, 1 Feb 2026 ↗)
Authors' conclusion
Following TNFi initiation, antimicrobial use rose temporarily, with no significant increase in SI.
Study context
- Population
- Patients with PsA initiating tumor necrosis factor inhibitor (TNFi) from 2005 to 2018, Iceland (ICEBIO registry), and general-population comparatorsmatched cohort
- Participants
- 399 vs 1,986
- Exposure
- PsA patients before vs after TNFi initiation, and vs matched general-population comparators
- PsAn = 399
- Comparatorsn = 1,986reference
- Outcome
- Antimicrobial use and SI (infection-related hospitalizations) before and after TNFi initiation
- Follow-up
- 2 years before and after initiating TNFi
Methodological detailsmatched by age, sex and calendar time, 5 general-population comparators per patient, registry-based
- Matched by age, sex and calendar time
- 5 general-population comparators per patient
- Registry-based
Main finding
As reported in the abstract
Mean antimicrobial prescriptions per year before TNFi, patients vs comparators
1.26 vs 0.60
P < 0.001
Mean prescriptions in the 12 months after TNFi initiation, then returned to baseline
1.64
P < 0.001
Adjusted HR for an antimicrobial prescription in PsA after vs before TNFi initiation
1.43
95% CI 1.18–1.72P < 0.001
Observational data: associations, not effects.
Safety
Serious infections (SI) (infection-related hospitalizations)
- No statistically significant increase in SI
Original publication
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