The effect of antimalarials on the safety and persistence of treatment with biologic agents or Janus kinase inhibitors in rheumatoid arthritis
Main finding · SAEsResult — go to the resultmIRR 0.49 95% CI 0.36–0.68Authors' conclusion
Among RA patients on treatment with bDMARDs or JAKi, concomitant use of antimalarials was associated with reduced the incidence of serious and total AEs and with longer treatment course survival.
Study context
- Population
- Brazilian RA patients starting their first bDMARD or Janus kinase inhibitor (JAKi) (BiobadaBrasil registry), recruited January 2009 to October 2019, followed over up to six treatment courses2,335 treatment courses, 6711 PY
- Participants
- 1,316 patients
- Exposure
- Concomitant antimalarials vs no antimalarials in RA patients on bDMARDs or JAKi
- Outcome
- Incidence of serious adverse events (SAEs)
Methodological detailsmulticentre, negative binomial regression with generalized estimating equations, frailty Cox proportional hazards models
- Multicentre
- Negative binomial regression with generalized estimating equations
- Frailty Cox proportional hazards models
Main finding
SAEs
mIRR
0.49
95% CI 0.36–0.68
P < 0.001
As reported in the abstract
- Overall incidence of serious adverse events (SAEs)
- 9.2/100 PY
Observational data: associations, not effects.
Secondary outcomes
| Outcome | P value |
|---|---|
| Treatment course survivalBetter survival of treatment course with antimalarials | P = 0.003 |
Safety
| Outcome | mIRR (95% CI) | P value |
|---|---|---|
| Total AEs | 0.68 (0.56–0.81) | P < 0.001 |
| Serious infections | 0.53 (0.34–0.84) | P = 0.007 |
| Total hepatic AEs | 0.21 (0.05–0.85) | P = 0.028 |
Cardiovascular adverse events (AEs)
- No significant increase in the risk of cardiovascular AEs
Original publication
The effect of antimalarials on the safety and persistence of treatment with biologic agents or Janus kinase inhibitors in rheumatoid arthritis. Rheumatology (Oxford). Published 22 May 2023. doi:10.
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