Spondyloarthritis & psoriatic arthritis
Is the risk of infection higher during treatment with secukinumab than with TNF inhibitors? An observational study from the Nordic countries
Main finding · First-year hospitalized infection (IR per 100 patient-years, 95% CI)Result — go to the resultAdjusted hazard ratio 0.58 CI 0.39–0.85Authors' conclusion
When used according to clinical practice in the Nordic countries, the observed first-year absolute risk of hospitalized infection was doubled for secukinumab compared with adalimumab. This excess risk seemed largely explained by confounding by indication.
Study context
- Population
- Patients with SpA and PsA starting secukinumab or TNF inhibitors (TNFi) 2015 through 2018, four Nordic rheumatology registers7,708 SpA, 5760 PsA
- Participants
- 1,948 / 16,229 / 3,201
- Exposure
- Secukinumab vs TNFi
- Secukinumabn = 1,948reference
- TNFin = 16,229
- Adalimumabn = 3,201
- Outcome
- First hospitalized infection during the first year of treatment
- Follow-up
- First year of treatment
Methodological detailsfour Nordic rheumatology registers, linkage to national registers, Cox regression, sensitivity analyses for confounding by indication
- Four Nordic rheumatology registers
- Linkage to national registers
- Cox regression
- Sensitivity analyses for confounding by indication
Main finding
As reported in the abstract
First-year hospitalized infection (IR per 100 patient-years, 95% CI)
Adjusted hazard ratio
0.58
CI 0.39–0.85
By group
Adalimumabvs Secukinumab
aHR 0.58 (CI 0.39–0.85)
Observational data: associations, not effects.
Further findings
Sensitivity analyses
- Difference from secukinumab somewhat attenuated and in some analyses no longer statistically significant
Original publication
Is the risk of infection higher during treatment with secukinumab than with TNF inhibitors? An observational study from the Nordic countries. Rheumatology (Oxford). Published 20 June 2022. doi:10.
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