Risk of severe infections after the introduction of biologic DMARDs in people with newly diagnosed rheumatoid arthritis: a population-based interrupted time-series analysis
Authors' conclusion
RA onset after bDMARDs introduction was associated with an elevated severe infection risk in RA patients compared with matched non-RA individuals.
Study context
- Population
- People newly diagnosed with RA and matched non-RA individuals, administrative data (1990–2015), British Columbia, Canadaquarterly cohorts by index date
- Participants
- 60,226 vs 588,499
- Exposure
- RA vs matched general population controls without inflammatory arthritis, index date pre-bDMARDs (1995-2001) vs post-bDMARDs (2003-2007)
- RAn = 60,226
- Controlsn = 588,499reference
- Outcome
- Severe infections necessitating hospitalization or occurring during hospitalization after the index date; 8-year severe infection rates, pre- vs post-bDMARDs secular trends
- Follow-up
- 8 years
Methodological detailspopulation-based, interrupted time-series analysis, controls matched on age and gender
- Population-based
- Interrupted time-series analysis
- Controls matched on age and gender
Main finding
As reported in the abstract
Adjusted difference between pre- and post-bDMARD secular trends in 8-year severe infection rates
Adjusted difference between pre- and post-bDMARDs secular trends
1.85
P = 0.001
RA vs Controls
Adjusted difference between pre- and post-bDMARDs secular trends
0.12
P = 0.29
Non-RA
Observational data: associations, not effects.
Further findings
| Outcome | RA | Controls |
|---|---|---|
| Severe infections identified | 14 245 events | 79 819 events |
Original publication
Risk of severe infections after the introduction of biologic DMARDs in people with newly diagnosed rheumatoid arthritis: a population-based interrupted time-series analysis. Rheumatology (Oxford). Published 4 April 2023. doi:10.
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