ArticleArthritis care & research2012
Use of a disease risk score to compare serious infections associated with anti-tumor necrosis factor therapy among high- versus lower-risk rheumatoid arthritis patients.
Article in Arthritis care & research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- Effect of Anti-TNF Antibodies on Clinical Response in Rheumatoid Arthritis Patients: A Meta-Analysis.BioMed research international · 2016Pooled it
- Development of prediction models to select older RA patients with comorbidities for treatment with chronic low-dose glucocorticoids.Rheumatology (Oxford, England) · 2023Trial
- Use of a baseline risk score to identify the risk of serious infectious events in patients with rheumatoid arthritis during certolizumab pegol treatment.Arthritis research & therapy · 2017Trial
- Rheumatoid Arthritis: A Comprehensive Review of Etiology, Pathophysiology, and Innovative Therapeutic Advancements.Current pharmaceutical design · 2026Review
- Socioeconomic vulnerability and osteoporosis treatment disparities during COVID-19 lockdown among U.S. medicare enrollees who initiated romosozumab.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Influenza Vaccination Among Patients Undergoing Treatment for Rheumatological Disorders: Awareness, Vaccination Rates, and Influencing Factors.Archives of rheumatology · 2025Article
- Increased susceptibility to pneumonia due to tumour necrosis factor inhibition and prospective immune system rescueFrontiers in cellular and infection microbiology · 2022Review
- Age-based (<65 vs ≥65 years) incidence of infections and serious infections with tofacitinib versus biological DMARDs in rheumatoid arthritis clinical trials and the US Corrona RA registry.Annals of the rheumatic diseases · 2021Article
- Haematological abnormalities in new-onset rheumatoid arthritis and risk of common infections: a population-based study.Rheumatology (Oxford, England) · 2020Article
- Update on the Pathomechanism, Diagnosis, and Treatment Options for Rheumatoid Arthritis.Cells · 2020Review
- Early Lyme Borreliosis in Patients Treated with Tumour Necrosis Factor-Alfa Inhibitors.Journal of clinical medicine · 2019Article
- Prediction of infection risk in rheumatoid arthritis patients treated with biologics: are we any closer to risk stratification?Current opinion in rheumatology · 2019Review
- Management of inflammatory rheumatic conditions in the elderly.Rheumatology (Oxford, England) · 2019Review
- Impact of Sustained Remission on the Risk of Serious Infection in Patients With Rheumatoid Arthritis.Arthritis care & research · 2018Article
- Dose relationship between oral glucocorticoids and tumor necrosis factor inhibitors and the risk of hospitalized infectious events among patients with rheumatoid arthritis.Rheumatology international · 2017Article
- Comparative Rates of Serious Infections Among Patients With Systemic Lupus Erythematosus Receiving Immunosuppressive Medications.Arthritis & rheumatology (Hoboken, N.J.) · 2017Article
- Risk of hospitalised infection in rheumatoid arthritis patients receiving biologics following a previous infection while on treatment with anti-TNF therapy.Annals of the rheumatic diseases · 2015Article
- Pneumocystis jirovecii pneumonia in patients receiving tumor-necrosis-factor-inhibitor therapy: implications for chemoprophylaxis.Current rheumatology reports · 2014Review
- Older age at rheumatoid arthritis onset and comorbidities correlate with less Health Assessment Questionnaire-Disability Index and Clinical Disease Activity Index response to etanercept in the RADIUS 2 registry.Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases · 2014Article
- Evaluation of the RABBIT Risk Score for serious infections.Annals of the rheumatic diseases · 2014Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo evaluate whether rates of serious infection with anti-tumor necrosis factor (anti-TNF) therapy in rheumatoid arthritis (RA) patients differ in magnitude by specific drugs and patient characteristics.
methodsAmong new nonbiologic disease-modifying antirheumatic drug users enrolled in Medicare and Medicaid or a large US commercial health plan, we created and validated a person-specific infection risk score based on age, demographics, insurance type, glucocorticoid dose, and comorbidities to identify patients at high risk for hospitalized infections. We then applied this risk score to new users of infliximab, etanercept, and adalimumab and compared the observed 1-year rates of infection to one another and to the predicted infection risk score estimated in the absence of anti-TNF exposure.
resultsAmong 11,657 RA patients initiating anti-TNF therapy, the observed 1-year rate of infection was 14.2 infections per 100 person-years in older patients (age ≥65 years) and 4.8 in younger patients (age <65 years). There was a relatively constant rate difference of ~1-4 infections per 100 person-years associated with anti-TNF therapy across the range of the infection risk score. Infliximab had a significantly greater adjusted rate of infection compared to etanercept and adalimumab in both high- and lower-risk RA patients.
conclusionThe rate of serious infections for anti-TNF agents was incrementally increased by a fixed absolute difference irrespective of age, comorbidities, and other factors that contributed to infections. Older patients and those with high comorbidity burdens should be reassured that the magnitude of their incremental risk with anti-TNF agents is not greater than for lower-risk patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.