ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 958

Tocilizumab and the Risk for Cardiovascular Disease Events Among Rheumatoid Arthritis Patients: A Direct Comparison in Real World Setting

Fenglong Xie1, Huifeng Yun1, Emily Levitan2, Paul M. Muntner2 and Jeffrey R. Curtis1, 1University of Alabama at Birmingham, Birmingham, AL, 2Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Cardiovascular disease, rheumatoid arthritis (RA) and tocilizumab

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Sunday, October 21, 2018

Title: 3S108 ACR Abstract: RA–Treatments II: Safety (958–963)

Session Type: ACR Concurrent Abstract Session

Session Time: 4:30PM-6:00PM

Background/Purpose: Multiple studies have observed unfavorable changes in lipid profile associated with tocilizumab (TCZ, anti-IL6 receptor antagonists) and some other rheumatoid arthritis (RA) therapies. The real-world cardiovascular disease (CVD) risk associated with the first anti IL-6R medication for RA, TCZ, remains uncertain. Our objective was to assess the CVD risk associated with TCZ compared to individual tumor necrosis inhibitor (TNFi) therapies, as well as to other biologics used for RA (e.g. rituximab, abatacept).

Methods: Using 2006-2015 Medicare and MarketScan claims data, we conducted a retrospective cohort study among RA patients who initiated biologic disease-modifying antirheumatic drugs (bDMARDS) after January 1, 2010 and had at least 365 days medical and pharmacy coverage before initiation. The primary outcome was a composite of myocardial infarction (MI), stroke, and fatal CVD assessed using a validated method. Subgroups analyses were done for RA patients experienced to other bDMARDs before initiation and by stratifying patients with respect to key CVD risk factors to identify both higher and lower CVD risk patients. Incidence rates and 95% confidence intervals were calculated using Poisson regression. COX regression was used to generate unadjusted and adjusted hazard ratio.

Results: We identified 354,486 RA patients and 463,446 initiations of bDMARDS. After applying inclusion and exclusion criteria, the final cohort contained 88,463 RA patients and 117,493 episodes. The mean (SD) age was 64.7 in Medicare and 52.2 in MarketScan. The majority were female (83.9% Medicare; 80.5% MarketScan), and 68.6% were non-Hispanic White in Medicare. TCZ users were similar to abatacept and rituximab users except that TCZ users were less likely to be naïve to bDMARDS. Compared to TNFi users, TCZ users were likely to be white, have a history of CVD (other than MI or stroke), heart failure, atrial fibrillation, hospitalization, and more physician visits in baseline. TCZ users were less likely to be diabetic, use methotrexate in baseline, and naïve to bDMARDS.

The crude incidence rate (IR) per 1000 patient-years for composite CVD among Medicare patients ranged from 13.3 (95%CI: 11.1-16.0) for etanercept to 19.4 (95%CI: 16.3-20.9) for rituximab users. The crude incidence rate for pooled TNFi users was 16.4 (15.2-17.7). Compared to TCZ, the adjusted hazard ratios were 1.03 (0. 82-1.29) for abatacept, 1.25 (0.96-1.61) for rituximab, 1.13 (0.84-1.52) for etanercept, 1.33 (0.99-1.80) for adalimumab, and 1.57 (1.21-2.05) for infliximab (Figure). There were no significant differences in CVD risk between tocilizumab and any other biologic using MarketScan data.

Conclusion: Consistent with findings of a recently completed safety trial in RA, tocilizumab was associated with a comparable CVD risk compared to etanercept, as well as a number of other RA biologics, in two large data sources.


Disclosure: F. Xie, None; H. Yun, Bristol Myers Squibb, 2; E. Levitan, Amgen Inc., 2, 5,Novartis, 5; P. M. Muntner, None; J. R. Curtis, Amgen Inc., 2, 5,AbbVie Inc., 2, 5,BMS, 2, 5,Corrona, LLC, 2, 5,Janssen, 2, 5,Eli Lilly, 2, 5,Myriad, 2, 5,Pfizer, Inc., 2, 5,Roche/Genentech, 2, 5,Radius, 2, 5,UCB, Inc., 2, 5.

To cite this abstract in AMA style:

Xie F, Yun H, Levitan E, Muntner PM, Curtis JR. Tocilizumab and the Risk for Cardiovascular Disease Events Among Rheumatoid Arthritis Patients: A Direct Comparison in Real World Setting [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/tocilizumab-and-the-risk-for-cardiovascular-disease-events-among-rheumatoid-arthritis-patients-a-direct-comparison-in-real-world-setting/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/tocilizumab-and-the-risk-for-cardiovascular-disease-events-among-rheumatoid-arthritis-patients-a-direct-comparison-in-real-world-setting/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology