Risk of dyslipidemia and major adverse cardiac events with tofacitinib versus adalimumab in rheumatoid arthritis: a real-world cohort study from 7580 patients

Xiao-Na Ma; Mei-Feng Shi; Shiow-Ing Wang; Wei Feng; Shu-Lin Chen; Xiao-Qin Zhong; Qing-Ping Liu; James Cheng-Chung Wei; Chang-Song Lin; Qiang Xu

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

Front Pharmacol. 2024 May 31:15:1370661. doi: 10.3389/fphar.2024.1370661. eCollection 2024.

Authors

Xiao-Na Ma^#^{1

2}, Mei-Feng Shi^#^{1

2}, Shiow-Ing Wang^#^{3

4}, Wei Feng^{1

2}, Shu-Lin Chen^{1

2}, Xiao-Qin Zhong^{1

2}, Qing-Ping Liu^{1

2}, James Cheng-Chung Wei^{4

5

6

7

8}, Chang-Song Lin^{1

2}, Qiang Xu^{1

2}

Affiliations

¹ State Key Laboratory of Traditional Chinese Medicine Syndrome, The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
² Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
³ Center for Health Data Science, Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.
⁴ Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
⁵ Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan.
⁶ Department of Nursing, Chung Shan Medical University, Taichung, Taiwan.
⁷ Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
⁸ Office of Research and Development, Asia University, Taichung, Taiwan.

^# Contributed equally.

Abstract

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 7,580 newly diagnosed patients with RA (1998 receiving tofacitinib, 5,582 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]).

Conclusion: 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: TriNetX; adalimumab; lipidemias; risk factors; tofacitinib.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. Funding for this study was provided by Natural Science Foundation of Department of Education of Guangdong Province Grant 2022KTSCX030. Funding sources did not contribute to the study design, statistical analysis, interpretation, or manuscript preparation.