Evidence map›Paper›PMID 36854568›Full record

Observational studyRMD open2023

Exposure to specific tumour necrosis factor inhibitors and risk of demyelinating and inflammatory neuropathy in cohorts of patients with inflammatory arthritis: a collaborative observational study across five Nordic rheumatology registers.

Benedicte Delcoigne, Tine Iskov Kopp, Elizabeth V Arkema, Karin Hellgren, Sella Aarrestad Provan, Heikki Relas, Kalle Aaltonen, Nina Trokovic, Bjorn Gudbjornsson, Gerdur Grondal and 4 more

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in RMD open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 9 institutions in 8 countries.

Benedicte DelcoigneDepartment of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden benedicte.delcoigne@ki.se.ORCID 0000-0002-2716-5679
Tine Iskov KoppDepartment of Neurology, Copenhagen University Hospital, Kobenhavn, Denmark.
Elizabeth V ArkemaDepartment of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-3677-9736
Karin HellgrenDepartment of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0001-7149-0973
Sella Aarrestad ProvanCenter for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.ORCID 0000-0001-5442-902X
Heikki RelasDepartment of Medicine, Division of Rheumatology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
Kalle AaltonenROB-FIN, Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland.
Nina TrokovicDepartment of Medicine, Division of Rheumatology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
Bjorn GudbjornssonFaculty of Medicine, University Hospital of Iceland, Reykjavik, Iceland.ORCID 0000-0003-4631-6505
Gerdur GrondalDepartment of Rheumatology Research, Landspitali University Hospital, Reykjavik, Iceland.
Eirik Klami KristianslundCenter for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.
Jesper LindhardsenDepartment of Rheumatology, Rigshospitalet, Copenhagen University, Copenhague, Denmark.
Lene DreyerCenter of Rheumatic Research Aalborg (CERRA), Aalborg University, Aalborg, Denmark.
Johan AsklingDepartment of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0003-0433-0616
Karolinska Institutet · SEInstitute for Rheumatic Diseases (Japan) · JPUniversity of Helsinki · FIAalborg University Hospital · DKCopenhagen University Hospital · DKFaculty (United Kingdom) · GBMinistry of Social Affairs and Health · FIReykjavík University · ISRigshospitalet · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare incidences of neuroinflammatory events, including demyelinating disease (DML), inflammatory polyneuropathies (IPN) and multiple sclerosis (MS), in patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA; including psoriatic arthritis) starting a tumour necrosis factor inhibitor (TNFi), investigating whether monoclonal TNFi antibodies (other TNFis (oTNFis)) confer higher risk than etanercept.

methodsThis is an observational cohort study including patients from the five Nordic countries starting a TNFi in 2001-2020. Time to first neuroinflammatory event was identified through register linkages. We calculated crude incidence rates (cIR) per 1000 person-years and used multivariable-adjusted Cox regression to compare incidences of neuroinflammatory events overall and for DML, IPN and MS with oTNFi versus etanercept. We further examined individual TNFis and indications.

results33 883 patients with RA and 28 772 patients with SpA were included, initiating 52 704 and 46 572 treatment courses, respectively. In RA, we observed 135 neuroinflammatory events (65% DML) with cIR of 0.38 with oTNFi and 0.34 with etanercept. The HR of oTNFi versus etanercept was 1.07 (95% CI 0.74 to 1.54) for any neuroinflammatory event, 0.79 (95% CI 0.51 to 1.22) for DML, 2.20 (95% CI 1.05 to 4.63) for IPN and 0.73 (95% CI 0.34 to 1.56) for MS. In SpA, we observed 179 events (78% DML) with cIR of 0.68 with oTNFi and 0.65 with etanercept. The HR for any neuroinflammatory event, DML, IPN and MS was 1.06 (95% CI 0.75 to 1.50), 1.01 (95% CI 0.68 to 1.50), 1.28 (95% CI 0.61 to 2.69) and 0.94 (95% CI0.53 to 1.69), respectively.

conclusionThe cIRs of neuroinflammatory events are higher in SpA than in RA, but the choice of specific TNFi does not seem to play an important role in the risk of neuroinflammatory events.

Indexed as

Arthritis, PsoriaticArthritis, RheumatoidRheumatologyAntibodies, MonoclonalEtanerceptHumansTumor Necrosis Factor InhibitorsAntibodies, MonoclonalEtanerceptTumor Necrosis Factor InhibitorsArthritis, PsoriaticArthritis, RheumatoidSpondylitis, AnkylosingTumor Necrosis Factor Inhibitors

Identifiers

PMID36854568
PMCPMC9980369
OpenAlexW4322627256

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.