Table. Summary of Evidence.
| Source (study type) | Population source (study period) | Biologic cohort | Nonbiologic cohort | Estimate (95% CI) | Adjustment for confoundersa | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, mean, y/female, % | Patients receiving therapy, No. | Treatment duration, mean | Cases, No. | Age, mean, y/female, % | Patients receiving therapy, No. | Treatment duration, mean | Cases, No. | ||||
| IBD | |||||||||||
| Nyboe Andersen et al,32 2014 (cohort study) | The Danish National Patient Registry (1999-2012) | NR/56 | TNFI: 4553 | 3.7 y | 9 | NR/55 | IBD biologic naive: 51 593 | NR | 176 | RR, 1.31 (0.63-2.74) | Disease duration; use of methotrexate, cyclosporine-cyclophosphamide, and azathioprine |
| McAuliffe et al,30 2015 (cohort study) | The HealthCore Integrated Research Database (2004-2011) | NR/49 | TNFI: 3348 | 1.0 y | 1 | NR/49 | IBD biologic naive: 29 472 | NR | HR, 0.62 (0.08-4.75) | No additional adjustment performed | |
| RA | |||||||||||
| Dreyer et al,33 2013 (cohort study) | The Danish Registry for Biologic Therapies in Rheumatology (2000-2008) | 54.3/73 | TNFI: 3347 | 2.9 y | 6 | 61.2/74 | Nonbiologic DMARDs: 3812 | NR | 3 | HR, 1.54 (0.37-6.34) | Calendar time |
| Staples et al,34 2019 (cohort study) | The Australian Rheumatology Association Database (2001-2012) | 55.7/73.9 | TNFI: 2451 | 10 120 person-years | 12 | 62.4/70 | Nonbiologic DMARDs: 574 | 2232 person-years | 4 | RR, 1.18 (0.29-4.70) | Calendar year, smoking status, methotrexate use, and prior malignant tumor |
| Wadström et al,35 2017 (cohort study) | The Swedish Rheumatology Quality of Care Register (2006-2015) | 58/74 | TNFI: 10 744 | 4.83 y | 32 | 64/71 | Conventional systemic DMARDs: 46 315 | 5.9 y | 234 | HR, 0.84 (0.60-1.18) | Start of treatment year, comorbidities, No. of hospitalizations, educational level, and days spent in inpatient care |
| 61/70 | Abatacept: 2005 | 3.17 y | 7 | HR, 1.43 (0.66-3.09) | |||||||
| 63/76 | Rituximab: 3545 | 4.23 y | 9 | HR, 0.73 (0.38-1.39) | |||||||
| Wolfe and Michaud,36 2007 (cohort study) | US National Data Bank for Rheumatic Diseases (1998-2005) | 58.5/78 | Infliximab: 790 | 2.9 y | 11 | 58.5/78 | Biologic naive: NR | NR | NR | OR, 2.60 (1.00-6.70) | Educational level, smoking history, baseline patient activity scale, and baseline prednisone use |
| Etanercept: 754 | 2.7 y | 9 | OR, 2.40 (1.00-5.80) | ||||||||
| Adalimumab: 207 | 1.2 y | 1 | OR, 0.80 (0.10-6.60) | ||||||||
| Psoriasis | |||||||||||
| Asgari et al,31 2017 (cohort study) | Kaiser Permanente Northern California health insurance database (1998-2011) | 47.6/47 | Biologics: 2285 | 5.86 y | 8 | 62.4/51 | Nonbiologic systemic therapy: 3604 | 5.23 y | 13 | HR, 1.57 (0.61-4.09) | Race/ethnicity, presence of PsA; prior UV light therapy, BMI, and cigarette use |
Abbreviations: BMI, body mass index; DMARDs, disease-modifying antirheumatic drugs; HR, hazard ratio; NR, not reported; IBD, inflammatory bowel disease; OR, odds ratio; PsA, psoriatic arthritis; RA, rheumatoid arthritis; RR, relative risk; TNFI, tumor necrosis factor inhibitor.
a
All studies were adjusted for age and sex.