PMID- 37496244
OWN - NLM
STAT- MEDLINE
DCOM- 20240110
LR  - 20240110
IS  - 2212-3911 (Electronic)
IS  - 1574-8863 (Linking)
VI  - 19
IP  - 2
DP  - 2024
TI  - Multiple Sclerosis Risk Among Anti-tumor Necrosis Factor Alpha Users: A 
      Methodological Review of Observational Studies Based on Real-world Data.
PG  - 200-207
LID - 10.2174/1574886318666230726162245 [doi]
AB  - Epidemiologic studies on the risk of multiple sclerosis (MS) or demyelinating 
      events associated with anti-tumor necrosis factor alpha (TNFalpha) use among patients 
      with rheumatic diseases or inflammatory bowel diseases have shown conflicting 
      results. Causal directed acyclic graphs (cDAGs) are useful tools for 
      understanding the differing results and identifying the structure of potential 
      contributing biases. Most of the available literature on cDAGs uses language that 
      might be unfamiliar to clinicians. This article demonstrates how cDAGs can be 
      used to determine whether there is a confounder, a mediator or 
      collider-stratification bias and when to adjust for them appropriately. We also 
      use a case study to show how to control for potential biases by drawing a cDAG 
      depicting anti-TNFalpha use and its potential to contribute to MS onset. Finally, we 
      describe potential biases that might have led to contradictory results in 
      previous studies that examined the effect of anti-TNFalpha and MS, including 
      confounding, confounding by contraindication, and bias due to measurement error. 
      Clinicians and researchers should be cognizant of confounding, confounding by 
      contraindication, and bias due to measurement error when reviewing future studies 
      on the risk of MS or demyelinating events associated with anti-TNFalpha use. cDAGs 
      are a useful tool for selecting variables and identifying the structure of 
      different biases that can affect the validity of observational studies.
CI  - Copyright(c) Bentham Science Publishers; For any queries, please email at 
      epub@benthamscience.net.
FAU - Li, Lingyi
AU  - Li L
AD  - Experimental Medicine Program, University of British Columbia, Vancouver, British 
      Columbia, Canada.
AD  - Arthritis Research Canada, Vancouver, British Columbia, Canada.
FAU - Etminan, Mahyar
AU  - Etminan M
AD  - Experimental Medicine Program, University of British Columbia, Vancouver, British 
      Columbia, Canada.
AD  - Department of Ophthalmology and Visual Sciences, Medicine and Pharmacology, 
      University of British Columbia, Vancouver, British Columbia, Canada.
FAU - Kaplan, Gilaad G
AU  - Kaplan GG
AD  - Departments of Medicine and Community Health Sciences, University of Calgary, 
      Calgary, Alberta, Canada.
FAU - Tremlett, Helen
AU  - Tremlett H
AD  - Division of Neurology, Faculty of Medicine, University of British Columbia, 
      Vancouver, British Columbia, Canada.
AD  - The Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, 
      Canada.
FAU - Xie, Hui
AU  - Xie H
AD  - Arthritis Research Canada, Vancouver, British Columbia, Canada.
AD  - Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, 
      Canada.
FAU - Avina-Zubieta, J Antonio
AU  - Avina-Zubieta JA
AD  - Experimental Medicine Program, University of British Columbia, Vancouver, British 
      Columbia, Canada.
AD  - Arthritis Research Canada, Vancouver, British Columbia, Canada.
AD  - Division of Rheumatology, Faculty of Medicine, University of British Columbia, 
      Vancouver, British Columbia, Canada.
LA  - eng
PT  - Journal Article
PL  - United Arab Emirates
TA  - Curr Drug Saf
JT  - Current drug safety
JID - 101270895
RN  - 0 (Tumor Necrosis Factor-alpha)
SB  - IM
MH  - Humans
MH  - *Models, Statistical
MH  - *Multiple Sclerosis/drug therapy/epidemiology
MH  - Tumor Necrosis Factor-alpha
MH  - Bias
MH  - Necrosis
OTO - NOTNLM
OT  - Anti-TNFalpha
OT  - causal directed acyclic graphs
OT  - collider
OT  - confounding
OT  - mediation.
OT  - multiple sclerosis
EDAT- 2023/07/27 06:42
MHDA- 2024/01/10 06:42
CRDT- 2023/07/27 01:13
PHST- 2023/03/14 00:00 [received]
PHST- 2023/06/12 00:00 [revised]
PHST- 2023/06/27 00:00 [accepted]
PHST- 2024/01/10 06:42 [medline]
PHST- 2023/07/27 06:42 [pubmed]
PHST- 2023/07/27 01:13 [entrez]
AID - CDS-EPUB-133178 [pii]
AID - 10.2174/1574886318666230726162245 [doi]
PST - ppublish
SO  - Curr Drug Saf. 2024;19(2):200-207. doi: 10.2174/1574886318666230726162245.