Publications

Authors:

Scagnellato, Laura; Collesei, Antonio; Doria, Andrea; Cozzi, Giacomo; Lorenzin, Mariagrazia; Atzeni, Fabiola; Bugatti, Serena; Caporali, Roberto; Cauli, Alberto; Conti, Fabrizio; Corrado, Addolorata; Carletto, Antonio; Chimenti, Maria Sole; Foti, Rosario; Frediani, Bruno; Gerli, Roberto; Gorla, Roberto; Govoni, Marcello; Gremese, Elisa; Guiducci, Serena; Iagnocco, Annamaria; Iannone, Florenzo; Parisi, Simone; Rossini, Maurizio; Salaffi, Fausto; Santo, Leonardo; Sarzi Puttini, Piercarlo; Sebastiani, Marco; Semerano, Angelo; Ferraccioli, Gianfranco; Lapadula, Giovanni; Ramonda, Roberta

Title:

Comorbidities in the Spondyloarthritis GISEA Cohort: an average treatment effect analysis on patients treated with bDMARDs

Year:

2023

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Referee:

No

Name of journal:

Clinical and Experimental Rheumatology

ISSN of journal:

0392-856X

N° Volume:

42

Number or Folder:

1

Page numbers:

104-114

Keyword:

spondyloarthritis, DMARDs, rheumatology

Short description of contents:

Objectives: We aimed to investigate the effectiveness of tumour necrosis factor inhibitors (TNFi), anti-interleukin-17 or interleukin-12/23 monoclonal antibodies (anti-IL) on comorbidities in a cohort of patients with spondyloarthritis (SpA), using an average treatment effect (ATE) analysis. Methods: SpA patients from the multicentre Italian GISEA Registry were divided into groups according to pharmacological exposure: no treatment (G0), TNFi (G1) and non-responders to TNFi switched to anti-IL (G2). In each group, we recorded the prevalence and incidence of infectious, cardiopulmonary, endocrinological, gastrointestinal, oncologic, renal and neurologic comorbidities. Each comorbidity was then fitted for ATE and baseline features were evaluated for importance. Results: The main findings of this study comprising 4458 SpA patients relate to cancer, other gastrointestinal diseases (OGID) and fibromyalgia. ATE showed no increased risk of solid cancer in G1 (0.42 95% CI 0.20-0.85) and G2 (0.26 95% CI 0.08-0.71) vs. G0, with significantly higher incidence in G0 (14.07/1000 patient-years, p=0.0001). Conversely, a significantly higher risk of OGID and fibromyalgia was found in G1 (1.56 95% CI 1.06-2.33; 1.69 95% CI 1.05-2.68, respectively) and G2 (1.91 95% CI 1.05-3.24; 2.13 95% CI 1.14-3.41, respectively) vs. G0. No treatment risk reduction was observed in haematological malignancies, cardiovascular events and endocrinological comorbidities. Conclusions: Overall, our study confirms the safety of TNFi and anti-IL in SpA patients, albeit with some caveats pertaining to solid cancers, OGID and fibromyalgia. Furthermore, taking into consideration causality with observational data may yield more reliable and relevant clinical information.

Product ID:

135239

Handle IRIS:

11562/1105066

Last Modified:

October 19, 2024

Bibliographic citation:

Scagnellato, Laura; Collesei, Antonio; Doria, Andrea; Cozzi, Giacomo; Lorenzin, Mariagrazia; Atzeni, Fabiola; Bugatti, Serena; Caporali, Roberto; Cauli, Alberto; Conti, Fabrizio; Corrado, Addolorata; Carletto, Antonio; Chimenti, Maria Sole; Foti, Rosario; Frediani, Bruno; Gerli, Roberto; Gorla, Roberto; Govoni, Marcello; Gremese, Elisa; Guiducci, Serena; Iagnocco, Annamaria; Iannone, Florenzo; Parisi, Simone; Rossini, Maurizio; Salaffi, Fausto; Santo, Leonardo; Sarzi Puttini, Piercarlo; Sebastiani, Marco; Semerano, Angelo; Ferraccioli, Gianfranco; Lapadula, Giovanni; Ramonda, Roberta, Comorbidities in the Spondyloarthritis GISEA Cohort: an average treatment effect analysis on patients treated with bDMARDs «Clinical and Experimental Rheumatology» , vol. 42 , n. 1 , 2023 , pp. 104-114

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