ArticleEpidemiology (Cambridge, Mass.)2016
Tumor Necrosis Factor-α Inhibitor Use and the Risk of Incident Hypertension in Patients with Rheumatoid Arthritis.
Article in Epidemiology (Cambridge, Mass.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 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.
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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
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Safety of biological therapy in patients with rheumatoid arthritis in administrative health databases: A systematic review and meta-analysis.Frontiers in pharmacology · 2022Pooled it
- Review
- The Cardiovascular Safety of Tumour Necrosis Factor Inhibitors in Arthritic Conditions: A Structured Review with Recommendations.Rheumatology and therapy · 2025Review
- Cardiovascular Risk Factor and Atherosclerosis in Rheumatoid Arthritis (RA).Current cardiology reports · 2025Review
- Immunomodulatory Activity of Cytokines in Hypertension: A Vascular Perspective.Hypertension (Dallas, Tex. : 1979) · 2024Review
- Role of Inflammatory Cytokines in Rheumatoid Arthritis and Development of Atherosclerosis: A Review.Medicina (Kaunas, Lithuania) · 2023Review
- The Association of Tumor Necrosis Factor Inhibitor Use With Incident Hypertension in Ankylosing Spondylitis: Data From the PSOAS Cohort.The Journal of rheumatology · 2022Article
- Therapeutic targeting of inflammation in hypertension: from novel mechanisms to translational perspective.Cardiovascular research · 2021Review
- Tumour necrosis factor inhibitors reduce aortic stiffness progression in patients with long-standing rheumatoid arthritis.Arthritis research & therapy · 2021Article
- Identification of Candidate Genes Related to Synovial Macrophages in Rheumatoid Arthritis by Bioinformatics Analysis.International journal of general medicine · 2021Article
- Nonsteroidal Antiinflammatory Drug Use and Association With Incident Hypertension in Ankylosing Spondylitis.Arthritis care & research · 2020Article
- Article
- Pro-inflammatory Cytokines and Resistant Hypertension: Potential for Novel Treatments?Current hypertension reports · 2019Review
- Low serum IGF1 is associated with hypertension and predicts early cardiovascular events in women with rheumatoid arthritis.BMC medicine · 2019Observational
- Cardiovascular Outcomes of Calcium-Free vs Calcium-Based Phosphate Binders in Patients 65 Years or Older With End-stage Renal Disease Requiring Hemodialysis.JAMA internal medicine · 2019Observational
- Initiation of Disease-Modifying Therapies in Rheumatoid Arthritis Is Associated With Changes in Blood Pressure.Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases · 2018Article
- Hypertension as a cardiovascular risk factor in autoimmune rheumatic diseases.Nature reviews. Cardiology · 2018Review
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo compare the risk of incident hypertension between initiators of tumor necrosis factor (TNF)-α inhibitors and initiators of nonbiologic disease modifying antirheumatic drugs (hereafter referred to as nonbiologics) in rheumatoid arthritis patients taking methotrexate monotherapy.
methodsWe conducted a cohort study using insurance claims data (2001-2012) from the US. We identified initiators of use of either TNF-α inhibitors or nonbiologics. Subsequent exposure to these agents was measured monthly in a time-varying manner. The outcome of interest was incident hypertension, defined by a diagnosis and a prescription for an antihypertensive drug. Marginal structural models estimated hazard ratios (HRs) adjusted for both baseline and time-varying confounders. To validate the primary analysis, we designed a verification analysis to evaluate a known association between leflunomide (a nonbiologic disease modifying agent) and hypertension.
resultsWe identified 4,822 initiations of TNF-α inhibitor use and 2,400 of nonbiologic use. Crude incidence rates of hypertension per 1,000 person-years of follow-up were 36 (95% CI [confidence interval]: 32, 41) for the TNF-α inhibitor group and 42 (95% CI: 34, 51) for the nonbiologics group. The crude HR of TNF-α inhibitors versus nonbiologics for the risk of incident hypertension was 0.85 (95% CI: 0.67, 1.1). After adjusting for both baseline and time-varying covariates using marginal structural models, the HR was 0.95 (95% CI: 0.74, 1.2). In the verification analysis, the adjusted HR of incident hypertension was 2.3 (95% CI: 1.7, 3.0) in leflunomide initiators compared with methotrexate initiators.
conclusionTreatment with TNF-α inhibitors was not associated with a reduced risk of incident hypertension compared with nonbiologics in rheumatoid arthritis patients.See Video Abstract at http://links.lww.com/EDE/B36.
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