New-onset atrial fibrillation in seropositive rheumatoid arthritis: association with disease-modifying anti-rheumatic drugs treatment
Authors' conclusion
Although the number of subjects developing new-onset AF was small, MTX decreased and LEF increased incident AF in patients with RA.
Study context
- Population
- Patients newly diagnosed with seropositive RA (SPRA) between 2010 and 2020, South Korean Health Insurance Review and Assessment Service databasepatients with SPRA
- Participants
- 108,085 patients
- Comparison
- DMARD use vs non-use in patients with seropositive RA, for incident atrial fibrillation (AF)
- AF-affectedn = 2,629
- Outcome
- Incident (new-onset) AF
Methodological detailsnationwide claims database, matched 1:4 on age, sex, follow-up duration and index year of SPRA diagnosis, adjusted conditional logistic regression
- Nationwide claims database
- Matched 1:4 on age, sex, follow-up duration and index year of SPRA diagnosis
- Adjusted conditional logistic regression
Main finding
As reported in the abstract
Incident AF by DMARD use
Adjusted odds ratio
0.89
Methotrexate (MTX) use · decreased risk
Adjusted odds ratio
1.21
Leflunomide (LEF) use · increased risk
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Cumulative incidence of new-onset AF | SPRA 2.4% |
- Cumulative incidence of new-onset AF: proportion of females ∼67%
Comorbidities and AF risk (matched population)
- Pre-existing hypertension, CKD and HF associated with increased risk of AF
Incident AF by DMARD use, subgroups by age and sex
- Age ≥50 years: LEF and adalimumab increased AF
- Males: MTX decreased AF
- Females: LEF increased AF risk
Original publication
New-onset atrial fibrillation in seropositive rheumatoid arthritis: association with disease-modifying anti-rheumatic drugs treatment. Rheumatology (Oxford). Published 8 July 2023. doi:10.
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