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Roshini Claire Anthony, 5 days ago

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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
Roshini Claire Anthony, 5 days ago

Patients with mild hypertension who are at low risk for cardiovascular disease (CVD) do not appear to derive mortality or CVD benefit from antihypertensive treatments, raising questions on the need for treatment in this population, according to a recent study from England.

Pearl Toh, 09 Nov 2018
A personalized computerized neurofeedback intervention for training attention and memory shows potential in cognitive training for healthy elderly men, who improved in cognitive performance after the training, although no significant improvements were seen in the overall study population.
3 days ago
Type 1 diabetes impairs cognitive functioning in children, and this effect is exacerbated by extreme glycaemic levels, according to a recent meta-analysis.
Pearl Toh, 08 Nov 2018
The pneumonia-causing bacteria, Streptococcus pneumoniae (pneumococcus), can be spread through nose picking and rubbing after exposure of the hands to the bacteria — in addition to the conventionally known route of inhalation of airborne droplets, a study reveals.