Tumor Necrosis Factor-α Inhibitor Use and the Risk of Incident Hypertension in Patients with Rheumatoid Arthritis

Epidemiology
Rishi J DesaiSeoyoung C Kim

Abstract

To compare the risk of incident hypertension between initiators of tumor necrosis factor (TNF)-α inhibitors and initiators of nonbiologic disease modifying antirheumatic drugs (hereafter referred to as nonbiologics) in rheumatoid arthritis patients taking methotrexate monotherapy. We conducted a cohort study using insurance claims data (2001-2012) from the US. We identified initiators of use of either TNF-α inhibitors or nonbiologics. Subsequent exposure to these agents was measured monthly in a time-varying manner. The outcome of interest was incident hypertension, defined by a diagnosis and a prescription for an antihypertensive drug. Marginal structural models estimated hazard ratios (HRs) adjusted for both baseline and time-varying confounders. To validate the primary analysis, we designed a verification analysis to evaluate a known association between leflunomide (a nonbiologic disease modifying agent) and hypertension. We identified 4,822 initiations of TNF-α inhibitor use and 2,400 of nonbiologic use. Crude incidence rates of hypertension per 1,000 person-years of follow-up were 36 (95% CI [confidence interval]: 32, 41) for the TNF-α inhibitor group and 42 (95% CI: 34, 51) for the nonbiologics group. The crude HR of TNF-...Continue Reading

References

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Citations

Apr 18, 2018·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Joshua F BakerTed R Mikuls
Jul 13, 2019·Pharmacoepidemiology and Drug Safety·Rishi J DesaiUNKNOWN Biologics and Biosimilars Collective Intelligence Consortium (BBCIC) Switching Workgroup
Nov 28, 2019·Current Hypertension Reports·Mariana Rodrigues Pioli, Ana Paula de Faria
Aug 25, 2017·Nature Reviews. Cardiology·Elena BartoloniRoberto Gerli
Feb 21, 2021·Autoimmunity Reviews·Brook HadwenLillian Barra

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