An increased incidence of acute myocardial infarction has been noted in 47,193 Medicare patients aged >65 years initiating anti-TNF therapy for rheumatoid arthritis (RA), especially in those receiving etanercept (adjusted HR 1.3, 95% CI 1.0–1.8) or infliximab (adjusted HR 1.3, 95% CI 1.0–1.6) versus those taking abatacept. Tocilizumab might not increase the risk of coronary heart disease (adjusted HR 0.64, 95% CI 0.41–0.99), although absolute differences in event rates were small and data on cardiovascular risk factors and RA disease severity were lacking.
References
Zhang, J. et al. Comparative effects of biologics on cardiovascular risk among older patients with rheumatoid arthritis. Ann. Rheum. Dis. http://dx.doi.org/10.1136/annrheumdis-2015-207870 (2016)
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Barranco, C. Anti-TNF agent choice impacts cardiovascular risk. Nat Rev Rheumatol 12, 132 (2016). https://doi.org/10.1038/nrrheum.2016.15
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DOI: https://doi.org/10.1038/nrrheum.2016.15