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Abatacept vs TNFi reduces cardiovascular risk in RA patients

14 Sep 2018

Initiation of abatacept (ABA) vs tumour necrosis factor inhibitors (TNFi) leads to a 20-percent reduction in risk of cardiovascular disease (CVD) in a large cohort of insured patients with rheumatoid arthritis (RA), a US study has shown.

Of the 6,102 propensity score (PS)-matched pairs of ABA and TNFi initiators from Medicare and 6,934 pairs from MarketScan, 35.3 percent in the former and 14.0 percent in the latter had baseline CVD. In the overall ABA vs TNFi group, the hazard ratio (HR) for composite CVD was 0.67 (95 percent CI, 0.55–0.81) in Medicare and 1.08 (0.83–1.41) in MarketScan (combined HR, 0.79; 0.67–0.92).

The HRs among patients with baseline CVD were 0.71 (0.55–0.92) and 1.02 (0.68–1.51) in Medicare and MarketScan, respectively (combined HR, 0.79; 0.64–0.98).

“While this observational study is subject to potential residual confounding, our results were consistent in patients with baseline CVD,” the authors said.

To assess the cardiovascular safety of ABA vs TNFi in RA patients with and without underlying CVD, the authors identified RA patients who initiated ABA or TNFi using data from two large US insurance claims databases: Medicare (2008–2013) and Truven MarketScan (2006–2015).

Stratified by baseline CVD, ABA initiators were PS-matched to TNFi initiators to control for >60 covariates. The authors used Cox proportional hazards regression to estimate HR for a composite endpoint of CVD including myocardial infarction, stroke/transient ischaemic stroke or coronary revascularization in the PS-matched cohorts. An inverse variance-weighted fixed-effects model was used to combine HR from two databases.

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Most Read Articles
Tristan Manalac, 6 days ago
Atopic dermatitis appears to impair sleep quality, but not sleep duration, in children, particularly in those with more severe diseases, according to a new study.
13 Mar 2019
Individuals following a diet low in or free of meat are at lower risk of diabetes, and this protective association is partly attributable to having a lower body mass index when compared with regular meat eaters, according to a study.
4 days ago
Drinking coffee confers benefits for recurrence of hepatocellular carcinoma (HCC) and survival following orthotopic liver transplantation, a study has found.
13 Mar 2019
Vitamin E supplementation does not appear to contribute to blood pressure (BP) improvement, with results of a recent systematic review and meta-analysis showing decreases only in systolic (S)BP but no favourable effect on diastolic (D)BP and mean arterial pressure (MAP).