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Increase in risk of heart failure slight among younger anti-TNF-treated patients with RA, Crohn's disease
Thursday, November 15 2007 | Comments
What's This?
Relatively young patients with rheumatoid arthritis or Crohn's disease appear to face a minimal increase in risk of new-onset heart failure while receiving treatment with etanercept or infliximab, study data indicate.Researchers examined administrative claims from a large, geographically diverse U.S. health care organization from 1998 to 2002 to identify patients aged less than 50 years who had RA or CD. Rates of heart failure among patients who were exposed to infliximab or etanercept were compared with those of patients who received nonbiologic immunosuppressives.
A total of 4,018 patients were identified. Among these patients, there were 33 suspected cases of heart failure, 9 of which were deemed definite (n=5) or possible (n=4).
The results showed an incidence of heart failure among exposed patients with RA of 4.4 cases per 1,000 persons, compared with 1.0 case per 1,000 persons among unexposed patients with RA. This resulted in a number needed to harm (NNH) of 294. The absolute difference in incidence between exposed and unexposed patients with CD was 0.3 cases per 1,000 persons, resulting in an NNH of 3,333.
Compared with the unexposed patients, those with RA who were exposed to anti-tumor necrosis factor agents had a relative risk of heart failure of 4.3, whereas the exposed patients with CD had a relative risk of 1.2. Both of these differences were statistically insignificant.
"In conclusion, among younger persons with few cardiovascular comorbidities, we observed only a few presumed cases of incident heart failure and a relatively low absolute risk, even among those exposed to TNF-alpha antagonists," the authors wrote.
These findings were published online Oct. 15 ahead of print in the journal Rheumatology by Curtis JR, et al.
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