Comparative effects of biological and targeted synthetic DMARDs on incident chronic kidney disease in patients with rheumatoid arthritis
Authors' conclusion
TNFi use was associated with reduced CKD incidence, whereas JAKi showed a less protective association for kidney function in patients with RA.
Study context
- Population
- Patients with RA and baseline estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m² starting a b/tsDMARD, Japan3,068 treatment courses
- Participants
- 2,187 patients
- Exposure
- TNF inhibitor (TNFi), CTLA4-Ig, IL-6R inhibitor or Janus kinase inhibitor (JAKi) compared
- Outcome
- Incident CKD
Methodological detailspropensity score-based inverse probability weighting, inverse probability weighting (IPW) mixed-effect Cox proportional hazards models, linear mixed-effect models
- Propensity score-based inverse probability weighting
- IPW mixed-effect Cox proportional hazards models
- Linear mixed-effect models
Main finding
As reported in the abstract
up to 11 years of follow-up
Each group vs CTLA4-IgHazard ratio (95% CI)P value
TNFi
0.67(0.46–0.97)
P = 0.04JAKi
2.16(1.23–3.79)
P = 0.01Observational data: associations, not effects.
Further findings
ml/min/1.73 m²/year
| Outcome | CTLA4-Ig | JAKi | P value |
|---|---|---|---|
| eGFR trajectoryJAKi vs CTLA4-Ig · trajectory significantly greater in JAKi | −1.28 | −2.29 | P < 0.001 |
Original publication
Comparative effects of biological and targeted synthetic DMARDs on incident chronic kidney disease in patients with rheumatoid arthritis. Rheumatology (Oxford). Published 30 October 2024. doi:10.
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