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ORIGINAL RESEARCH article

Front. Pharmacol.
Sec. Pharmacoepidemiology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1370661

Risk of Dyslipidemia and Major Adverse Cardiac Events with Tofacitinib versus Adalimumab in Rheumatoid Arthritis: A Real-World Cohort Study from 7580 patients

Provisionally accepted
Xiao-Na Ma Xiao-Na Ma 1,2Wei Feng Wei Feng 1,2Shiow-Ing Wang Shiow-Ing Wang 3,4Mei-Feng Shi Mei-Feng Shi 1,2Shu-Lin Chen Shu-Lin Chen 1,2Xiao-Qin Zhong Xiao-Qin Zhong 1,2Qing-Ping Liu Qing-Ping Liu 1,2James C. Wei James C. Wei 5,6*Chang-Song Lin Chang-Song Lin 1,2*Qiang Xu Qiang Xu 1,2*
  • 1 Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
  • 2 The First Affiliated Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
  • 3 Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
  • 4 Institute of Medicine, College of Medicine, Chung Shan Medical University, Taichung, Taiwan
  • 5 Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
  • 6 Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan

The final, formatted version of the article will be published soon.

    Objective: To compare the effects of tofacitinib and adalimumab on the risk of adverse lipidaemia outcomes in patients with newly diagnosed rheumatoid arthritis (RA). Methods: Data of adult patients newly diagnosed with RA who were treated with tofacitinib or adalimumab at least twice during a 3-year period from 1 January 2018 to 31 December 2020, were enrolled in the TriNetX US Collaborative Network. Patient demographics, comorbidities, medications, and laboratory data were matched by propensity score at baseline. Outcome measurements include incidental risk of dyslipidemia, major adverse cardiac events (MACE) and all-cause mortality. Results: A total of 7580 newly diagnosed patients with RA (1998 receiving tofacitinib, 5582 receiving adalimumab) were screened. After propensity score matching, the risk of dyslipidaemia outcomes were higher in the tofacitinib cohort, compared with adalimumab cohort (hazard ratio [HR] with 95% confidence interval [CI], 1.250 [1.076-1.453]). However, there is no statistically significant differences between two cohorts on MACE (HR, 0.995 [0.760-1.303]) and all-cause mortality (HR, 1.402 [0.887-2.215]). Conclusions: Tofacitinib use in patients with RA may increase the risk of dyslipidaemia to some extent compared to adalimumab. However, there is no differences on MACE and all-cause mortality.

    Keywords: Tofacitinib, Adalimumab, lipidemias, Risk factors, TriNetX

    Received: 15 Jan 2024; Accepted: 13 May 2024.

    Copyright: © 2024 Ma, Feng, Wang, Shi, Chen, Zhong, Liu, Wei, Lin and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    James C. Wei, Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, 40201, Taiwan
    Chang-Song Lin, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China
    Qiang Xu, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.