Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
Department of Rheumatology and Clinical Immunology, Wakayama Medical University, Wakayama, Japan.
Mod Rheumatol. 2024 Feb 26;34(2):287-296. doi: 10.1093/mr/road031.
We compared the incidence rates of hospitalized infections (HIs) between tocilizumab (TCZ) and other biological/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in adults aged ≥75 years with rheumatoid arthritis (RA).
We used a Japanese claims database from Medical Data Vision Co., Ltd (Tokyo, Japan) to perform a retrospective longitudinal population-based study in patients with RA who were prescribed b/tsDMARDs between 2014 and 2019. We calculated adjusted risk ratios (aRRs) for HIs in three age groups (<65, ≥65 and <75, and ≥75 years).
Of 5506 patients, 2265 (41.1%) were <65 years, 1709 (31.0%) were 65-74 years, and 1532 (27.8%) were ≥75 years. Crude incidence rates (/100 person-years) of HIs were 3.99, 7.27, and 10.77, respectively. In the oldest group, aRRs (95% confidence interval) for HIs (b/tsDMARDs versus TCZ) were as follows: etanercept, 2.40 (1.24-4.61); adalimumab, 1.90 (0.75-4.83); golimumab, 1.21 (0.66-2.23); and abatacept, 0.89 (0.49-1.62). In the other age groups, the noticeable difference was a lower aRR of etanercept versus TCZ in the youngest group (0.30, 0.11-0.85).
In patients with RA aged ≥75 years, b/tsDMARDs have a similar risk of HIs to tocilizumab except for etanercept.
我们比较了托珠单抗（TCZ）和其他生物/靶向合成疾病修正抗风湿药物（b/tsDMARDs）在年龄≥75 岁的类风湿关节炎（RA）成年患者中的住院感染（HIs）发生率。
我们使用来自 Medical Data Vision Co.，Ltd.（日本东京）的日本索赔数据库，对 2014 年至 2019 年间接受 b/tsDMARDs 治疗的 RA 患者进行了回顾性纵向基于人群的研究。我们计算了三个年龄组（<65 岁、≥65 岁且<75 岁和≥75 岁）的 HIs 的调整风险比（aRR）。
在 5506 名患者中，2265 名（41.1%）<65 岁，1709 名（31.0%）为 65-74 岁，1532 名（27.8%）≥75 岁。HIs 的粗发生率（/100 人年）分别为 3.99、7.27 和 10.77。在年龄最大的组中，HIs（b/tsDMARDs 与 TCZ）的 aRR（95%置信区间）如下：依那西普，2.40（1.24-4.61）；阿达木单抗，1.90（0.75-4.83）；戈利木单抗，1.21（0.66-2.23）；和阿巴西普，0.89（0.49-1.62）。在其他年龄组中，年轻组中依那西普与 TCZ 的 aRR 较低（0.30，0.11-0.85），这是一个显著的差异。
在年龄≥75 岁的 RA 患者中，除了依那西普外，b/tsDMARDs 与 TCZ 相比，HIs 的风险相似。
