Herpes Zoster, Hepatitis C, and Tuberculosis Risk with Apremilast Compared to Biologics, DMARDs and Corticosteroids to Treat Psoriasis and Psoriatic Arthritis.
apremilast
hepatitis C
herpes zoster
psoriasis
psoriatic arthritis
tuberculosis
Journal
Clinical epidemiology
ISSN: 1179-1349
Titre abrégé: Clin Epidemiol
Pays: New Zealand
ID NLM: 101531700
Informations de publication
Date de publication:
2020
2020
Historique:
received:
22
11
2019
accepted:
24
01
2020
entrez:
28
2
2020
pubmed:
28
2
2020
medline:
28
2
2020
Statut:
epublish
Résumé
Psoriasis and psoriatic arthritis (PsA) are associated with an increased infection risk. In this cohort study of patients with treated psoriasis or PsA, we used MarketScan (2014-2018) to estimate rates of herpes zoster, hepatitis C (HepC) and tuberculosis (TB) with apremilast compared to other systemic treatments. Patients were exposed from first apremilast [APR], DMARD, TNF-inhibitor [TNF], IL-inhibitor [IL], or corticosteroids [CS] prescription after March 21, 2014. Study exposures were APR, DMARDs only, TNF-only, IL-only, CS-only, DMARDs+CS, TNF+DMARDs and/or CS, IL+DMARDs and/or CS. Cases had treated herpes zoster, HepC, or TB event. We calculated incidence rates (IRs) [95% confidence intervals] per 1000 patient-years. The study population included 131,604 patients. For herpes zoster (N=2271), IRs were highest for users of DMARDs+CS (12.5 [9.8-15.7]), CS-only (12.5 [10.4-14.1]), and TNF+DMARDs and/or CS (11.9 [10.6-13.4]), compared with DMARDs only (9.9 [8.7-11.2]). IRs were lowest for users of IL-only (6.7 [5.8-7.8]) and APR (7.0 [5.8-8.4]). IRs of HepC (N=150) and TB (N=81) were low and between-treatment differences were not significant. Rates of herpes zoster varied by treatment: highest among those who received polytherapy, lowest in users of apremilast only. IRs for HepC and TB were low for all exposures.
Identifiants
pubmed: 32104099
doi: 10.2147/CLEP.S239511
pii: 239511
pmc: PMC7024766
doi:
Types de publication
Journal Article
Langues
eng
Pagination
153-161Informations de copyright
© 2020 Hagberg et al.
Déclaration de conflit d'intérêts
Ms Katrina Wilcox Hagberg reports grants from Celgene Corp, during the conduct of the study. Ms Rebecca Persson reports grants from Celgene Corporation, during the conduct of the study; grants from Celgene Corporation and AbbVie Inc., outside the submitted work. Dr Catherine Vasilakis-Scaramozza reports grants from Celgene Corporation, during the conduct of the study. Dr Steve Niemcryk is an employee of Celgene Corp, and owns stock in Celgene Corp. Dr Michael Peng, Dr Maria Paris, and Dr Anders Lindholm are employees of Celgene Corp. Dr Susan Jick reports grants from Celgene Corp, during the conduct of the study. The authors report no other conflicts of interest in this work.
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