Anti–Tumor Necrosis Factor ’ Therapy and the Risk of Serious Bacterial Infections in Elderly Patients With Rheumatoid Arthritis

File Size120.8 KiB
DateAugust 31, 2013
Objective. To assess the association between the initiation of anti–tumor necrosis factor ’ (anti-TNF’) therapy and the risk of serious bacterial infections in routine care.

Methods. This was a cohort study of patients with rheumatoid arthritis (RA) in whom specific disease- modifying antirheumatic drugs (DMARDs) were initiated. Patients were Medicare beneficiaries ages 65 years and older (mean age 76.5 years) who were concurrently enrolled in the Pharmaceutical Assistance Contract for the Elderly provided by the state of Pennsylvania. A total of 15,597 RA patients in whom a DMARD was initiated between January 1, 1995 and December 31, 2003 were identified using linked data on all prescription drug dispensings, physician services, and hospitalizations. Initiation of anti-TNF’ therapy, cytotoxic agents other than methotrexate (MTX), noncytotoxic agents, and glucocorticoids was compared with initia- tion of MTX. The main outcome measure was serious bacterial infections that required hospitalization.