Table 3.
Incidence rates and adjusted HRs for liver outcomes with respect to periods of anti-TNF-α agent use in patients with immune-related diseases
| Overall | AS | IBD | PsA | RA | |
|
Incidence rate (per 10 000 person-years) |
|||||
| Composite outcome of cirrhosis, NAFLD or NASH | |||||
| Anti-TNF-α agent use | 76.4 | 92.7 | 88.7 | 79.0 | 65.0 |
| Anti-TNF-α agent non-use | 64.7 | 52.8 | 67.8 | 72.7 | 60.7 |
| Cirrhosis | |||||
| Anti-TNF-α agent use | 8.7 | 5.8 | 15.7 | 7.8 | 4.8 |
| Anti-TNF-α agent non-use | 9.3 | 5.3 | 12.1 | 7.0 | 6.6 |
| NAFLD or NASH | |||||
| Anti-TNF-α agent use | 72.6 | 86.2 | 77.2 | 71.6 | 68.1 |
| Anti-TNF-α agent non-use | 57.4 | 50.9 | 57.9 | 66.5 | 56.0 |
| Adjusted HR with respect to anti-TNF-α agent use (95% CI) | |||||
| Composite outcome | 1.47 (1.27 to 1.70) |
1.90 (1.09 to 3.31) |
≤4 years:* 1.58 (1.22 to 2.05) >4 years:* 3.41 (1.67 to 6.96) |
1.25 (0.88 to 1.76) |
1.30 (1.03 to 1.65) |
| Cirrhosis | 1.47 (0.96 to 2.23) |
1.69 (0.20 to 13.96) |
1.99 (1.12 to 3.51) |
1.54 (0.51 to 4.61) |
1.10 (0.48 to 2.57) |
| NAFLD or NASH | 1.53 (1.32 to 1.77) |
1.81 (1.02 to 3.21) |
≤4.5 years:* 1.59 (1.21 to 2.08) >4.5 years:* 3.90 (1.60 to 9.48) |
1.21 (0.84 to 1.74) |
1.47 (1.16 to 1.85) |
*Results of a piecewise Cox model due to a significant time interaction with anti-TNF-α agent use. After examination of the survival curve constructed in Simon and Makuch’s method, several cut-off time points were tested and the one with the lowest Akaike information criterion was selected.
AS, ankylosing spondylitis; IBD, inflammatory bowel disease; NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steatohepatitis; PsA, psoriatic arthritis; RA, rheumatoid arthritis; TNF, tumour necrosis factor.