PMID- 37216912
OWN - NLM
STAT- MEDLINE
DCOM- 20240205
LR  - 20240206
IS  - 1462-0332 (Electronic)
IS  - 1462-0324 (Linking)
VI  - 63
IP  - 2
DP  - 2024 Feb 1
TI  - The effect of antimalarials on the safety and persistence of treatment with 
      biologic agents or Janus kinase inhibitors in rheumatoid arthritis.
PG  - 456-465
LID - 10.1093/rheumatology/kead232 [doi]
AB  - OBJECTIVES: To test the association of use of antimalarials with the overall 
      safety of treatment in RA patients receiving one or multiple courses of biologic 
      (b)DMARDs or a Janus kinase inhibitor (JAKi). METHODS: BiobadaBrasil is a 
      multicentric registry-based cohort study of Brazilian patients with rheumatic 
      diseases starting their first bDMARD or JAKi. The present analysis includes RA 
      patients recruited from January 2009 to October 2019, followed up over one or 
      multiple (up to six) courses of treatment (latest date, 19 November 2019). The 
      primary outcome was the incidence of serious adverse events (SAEs). Total and 
      system-specific adverse events (AEs) and treatment interruption served as 
      secondary outcomes. Negative binomial regression with generalized estimating 
      equations (to estimate multivariate incidence rate ratios, mIRR) and frailty Cox 
      proportional hazards models were used for statistical analyses. RESULTS: The 
      number of patients enrolled was 1316 (2335 treatment courses, 6711 patient-years 
      [PY]; 1254.5 PY on antimalarials). The overall incidence of SAEs was 9.2/100 PY. 
      Antimalarials were associated with reduced risk of SAEs (mIRR: 0.49; 95% CI: 
      0.36, 0.68; P < 0.001), total AEs (0.68; 95% CI: 0.56, 0.81; P < 0.001), serious 
      infections (0.53; 95% CI: 0.34, 0.84; P = 0.007) and total hepatic AEs (0.21; 95% 
      CI: 0.05, 0.85; P = 0.028). Antimalarials were also related to better survival of 
      treatment course (P = 0.003). There was no significant increase in the risk of 
      cardiovascular AEs. CONCLUSION: Among RA patients on treatment with bDMARDs or 
      JAKi, concomitant use of antimalarials was associated with reduced the incidence 
      of serious and total AEs and with longer treatment course survival.
CI  - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the 
      British Society for Rheumatology. All rights reserved. For permissions, please 
      email: journals.permissions@oup.com.
FAU - Bredemeier, Markus
AU  - Bredemeier M
AUID- ORCID: 0000-0002-7911-593X
AD  - Hospital Nossa Senhora da Conceicao, Grupo Hospitalar Conceicao, Porto Alegre, 
      RS, Brazil.
FAU - Duarte, Angela L
AU  - Duarte AL
AD  - Hospital das Clinicas da Universidade Federal de Pernambuco, Recife, PE, Brazil.
FAU - Pinheiro, Marcelo M
AU  - Pinheiro MM
AUID- ORCID: 0000-0002-1896-8322
AD  - Universidade Federal de Sao Paulo/Escola Paulista de Medicina, Sao Paulo, SP, 
      Brazil.
FAU - Kahlow, Barbara S
AU  - Kahlow BS
AUID- ORCID: 0000-0001-5292-2777
AD  - Hospital Universitario Evangelico Mackenzie, Curitiba, PR, Brazil.
FAU - Macieira, Jose C
AU  - Macieira JC
AD  - Hospital Universitario da Universidade Federal de Sergipe, Aracaju, SE, Brazil.
FAU - Ranza, Roberto
AU  - Ranza R
AD  - Hospital das Clinicas da Universidade Federal de Uberlandia, Uberlandia, MG, 
      Brazil.
FAU - Miranda, Jose R
AU  - Miranda JR
AD  - Artrocenter Clinica Medica, Taubate, SP, Brazil.
FAU - Valim, Valeria
AU  - Valim V
AD  - Hospital Universitario Cassiano Antonio de Moraes, Universidade Federal do 
      Espirito Santo, Vitoria, ES, Brazil.
FAU - de Castro, Glaucio R
AU  - de Castro GR
AD  - Hospital Governador Celso Ramos, Florianopolis, SC, Brazil.
FAU - Bertolo, Manoel B
AU  - Bertolo MB
AD  - Hospital das Clinicas da Universidade Estadual de Campinas, Campinas, SP, Brazil.
FAU - Sauma, Maria F
AU  - Sauma MF
AD  - Universidade Federal do Para, Belem, PA, Brazil.
FAU - Fernandes, Vander
AU  - Fernandes V
AD  - Hospital Geral de Cuiaba, Cuiaba, MT, Brazil.
FAU - Ribeiro, Ana C
AU  - Ribeiro AC
AD  - Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao 
      Paulo, SP, Brazil.
FAU - Teodoro, Reginaldo B
AU  - Teodoro RB
AD  - Hospital de Clinicas da Universidade Federal do Triangulo Mineiro, Uberaba, MG, 
      Brazil.
FAU - Brenol, Claiton V
AU  - Brenol CV
AD  - Universidade Federal do Rio Grande do Sul/Hospital de Clinicas de Porto Alegre, 
      Porto Alegre, RS, Brazil.
FAU - Carvalho, Hellen M
AU  - Carvalho HM
AD  - Hospital de Base do Distrito Federal, Brasilia, DF, Brazil.
FAU - Studart, Samia A
AU  - Studart SA
AD  - Hospital Geral de Fortaleza, Fortaleza, CE, Brazil.
FAU - Pinheiro, Geraldo R
AU  - Pinheiro GR
AD  - Universidade Estadual do Rio de Janeiro/Hospital Universitario Pedro Ernesto, Rio 
      de Janeiro, RJ, Brazil.
FAU - da Rocha, Laurindo F Jr
AU  - da Rocha LF Jr
AD  - Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brazil.
FAU - de Lima, Hugo D
AU  - de Lima HD
AD  - Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brazil.
FAU - Pereira, Ivanio A
AU  - Pereira IA
AD  - Hospital Universitario da Universidade Federal de Santa Catarina, Florianopolis, 
      SC, Brazil.
FAU - Gazzeta, Morgana O
AU  - Gazzeta MO
AD  - Santa Casa de Misericordia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
FAU - Kakehasi, Adriana M
AU  - Kakehasi AM
AD  - Hospital das Clinicas da Universidade Federal de Minas Gerais, Belo Horizonte, 
      MG, Brazil.
FAU - Louzada, Paulo Jr
AU  - Louzada P Jr
AD  - Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto, Universidade de 
      Sao Paulo, Ribeirao Preto, SP, Brazil.
FAU - Hayata, Andre L
AU  - Hayata AL
AD  - Clinica de Reumatologia, Osasco, SP, Brazil.
FAU - Lupo, Cristiano M
AU  - Lupo CM
AD  - Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, SP, 
      Brazil.
FAU - da Silveira, Ines G
AU  - da Silveira IG
AD  - Faculdade de Medicina da Pontificia Universidade Catolica do Rio Grande do 
      Sul/Hospital Sao Lucas, Porto Alegre, RS, Brazil.
FAU - Kowalski, Sergio C
AU  - Kowalski SC
AD  - Hospital de Clinicas da Universidade Federal do Parana, Curitiba, PR, Brazil.
FAU - Titton, David C
AU  - Titton DC
AD  - Hospital de Clinicas da Universidade Federal do Parana, Curitiba, PR, Brazil.
FAU - Chakr, Rafael M
AU  - Chakr RM
AD  - Universidade Federal do Rio Grande do Sul/Hospital de Clinicas de Porto Alegre, 
      Porto Alegre, RS, Brazil.
FAU - Ranzolin, Aline
AU  - Ranzolin A
AD  - Hospital das Clinicas da Universidade Federal de Pernambuco, Recife, PE, Brazil.
FAU - Xavier, Ricardo M
AU  - Xavier RM
AUID- ORCID: 0000-0001-6570-4533
AD  - Universidade Federal do Rio Grande do Sul/Hospital de Clinicas de Porto Alegre, 
      Porto Alegre, RS, Brazil.
FAU - Laurindo, Ieda M
AU  - Laurindo IM
AD  - Faculdade de Medicina da Universidade Nove de Julho, Sao Paulo, SP, Brazil.
LA  - eng
GR  - Brazilian Society of Rheumatology/
PT  - Journal Article
PL  - England
TA  - Rheumatology (Oxford)
JT  - Rheumatology (Oxford, England)
JID - 100883501
RN  - 0 (Janus Kinase Inhibitors)
RN  - 0 (Antimalarials)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Biological Products)
SB  - IM
MH  - Humans
MH  - *Janus Kinase Inhibitors/adverse effects
MH  - *Antimalarials/adverse effects
MH  - Cohort Studies
MH  - *Arthritis, Rheumatoid/epidemiology
MH  - *Antirheumatic Agents/adverse effects
MH  - *Biological Products/therapeutic use
OTO - NOTNLM
OT  - JAK inhibitors
OT  - RA
OT  - adverse events
OT  - antimalarials
OT  - biologics
OT  - hydroxychloroquine
OT  - safety
EDAT- 2023/05/23 01:06
MHDA- 2024/02/05 06:43
CRDT- 2023/05/22 18:13
PHST- 2023/01/04 00:00 [received]
PHST- 2023/05/10 00:00 [accepted]
PHST- 2024/02/05 06:43 [medline]
PHST- 2023/05/23 01:06 [pubmed]
PHST- 2023/05/22 18:13 [entrez]
AID - 7175419 [pii]
AID - 10.1093/rheumatology/kead232 [doi]
PST - ppublish
SO  - Rheumatology (Oxford). 2024 Feb 1;63(2):456-465. doi: 
      10.1093/rheumatology/kead232.