Setoguchi S et al. – TNF-α antagonists (TNFAs) may increase the risk of both first hospitalization and exacerbation of heart failure (HF) in elderly patients with RA; larger and more detailed studies are needed to confirm the findings. Methods
Aim was to determine if TNFAs pose an increased risk of HF in older pts with RA
Data from Medicare and drug benefit programs in 2 states
RA pts aged ≥65, who received TNFA or MTX
The cohort was divided into pts with and w/o previous HF
Demographic variables, cv risk factors, RA severity-related measures, and other comorbidities were considered
The primary end point was hospitalization with HF
Adjusted effect of TNFAs on HF hospitalization was estimated
Results
1,002 TNFA users and 5,593 MTX users
59 HF admissions during 1,680 person-years of TNFA use; 227 HF admissions during 10,623 person-years of MTX use
Adjusted hazard ratio for HF hospitalization was 1.70
Similar results were found in pts with and w/o previous HF
Among pts with previous HF, the adjusted hazard ratio for death was 4.19
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