Exposure to specific tumour necrosis factor inhibitors and risk of demyelinating and inflammatory neuropathy in cohorts of patients with inflammatory arthritis: a collaborative observational study across five Nordic rheumatology registers
Main finding · Any neuroinflammatory event, RAResult — go to the resultHazard ratio 1.07 95% CI 0.74–1.54Authors' conclusion
The cIRs of neuroinflammatory events are higher in SpA than in RA, but the choice of specific TNFi does not seem to play an important role in the risk of neuroinflammatory events.
Study context
- Population
- Patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA) (including PsA) starting a tumour necrosis factor inhibitor (TNFi) in the five Nordic countries, 2001–202033,883 RA and 28,772 SpA patients
- Exposure
- Monoclonal TNFi antibodies vs etanercept
- Outcome
- Time to first neuroinflammatory event:
- DML
- Inflammatory polyneuropathies (IPN)
- Multiple sclerosis (MS)
Methodological detailsmultinational (five Nordic rheumatology registers), register linkage, multivariable-adjusted Cox regression, 52 704 (RA) and 46 572 (SpA) treatment courses
- Multinational (five Nordic rheumatology registers)
- Register linkage
- Multivariable-adjusted Cox regression
- 52 704 (RA) and 46 572 (SpA) treatment courses
Main finding
Any neuroinflammatory event, RA
Hazard ratio
1.07
95% CI 0.74–1.54
By group
oTNFivs Etanercept
HR 1.07 (95% CI 0.74–1.54)
As reported in the abstract
Observational data: associations, not effects.
Further findings
Crude incidence rates (cIR), per 1000 person-years
| Outcome | oTNFi | Etanercept | Estimate | |
|---|---|---|---|---|
| Any neuroinflammatory event, SpA | 0.68 | 0.65 | HR 1.06 (95% CI 0.75–1.50) | |
| DML, IPN and MS, RA | HR (DML) 0.79 (95% CI 0.51–1.22) | |||
| DML, IPN and MS, RA | HR (IPN) 2.20 (95% CI 1.05–4.63) | |||
| DML, IPN and MS, RA | HR (MS) 0.73 (95% CI 0.34–1.56) | |||
| DML, IPN and MS, SpA | HR (DML) 1.01 (95% CI 0.68–1.50) | |||
| DML, IPN and MS, SpA | HR (IPN) 1.28 (95% CI 0.61–2.69) | |||
| DML, IPN and MS, SpA | HR (MS) 0.94 (95% CI 0.53–1.69) | |||
| 0.20.5125Ratio (log scale) |
- Any neuroinflammatory event, SpA: 179 events in SpA (78% DML)
Original publication
Exposure to specific tumour necrosis factor inhibitors and risk of demyelinating and inflammatory neuropathy in cohorts of patients with inflammatory arthritis: a collaborative observational study across five Nordic rheumatology registers. RMD Open. Published 28 February 2023. doi:10.
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