Rheumatology: Current Research
Open Access
ISSN: 2161-1149 (Printed)
ISSN: 2161-1149 (Printed)
Lene Dreyer
Gentofte University Hospital, Denmark
Posters & Accepted Abstracts: Rheumatology (Sunnyvale)
Background: Evidence of tumor necrosis factor-�?± (TNF) as an important factor in the pathogenesis of multiple sclerosis (MS) has emerged. However, attempts of treating MS with TNF-inhibitors (TNFi) have increased disease activity. Objectives: To investigate whether TNFi treatment in arthritis patients is associated with an increased risk of developing MS and if rheumatoid arthritis (RA) is associated with a decreased risk compared to the general population. Methods: Data from the national DANBIO Registry and the Danish Multiple Sclerosis Registry was linked. A cohort of 27,875 patients with arthritis (64% RA patients) was followed up for MS. During follow-up 2000-2012, 10,296 patients started TNFi therapy. Standardized Incidence Ratios (SIR) of MS was estimated using standardized incidence rates from the general populations and person-years at risk. Results: During 113,527 person-years, 12 incident MS cases occurred in the cohort, overall SIR=1.11(95% CI 0.63-1.96). SIR for arthritis patients ever treated with TNFi therapy was 1.38(95% CI 0.69-2.77, N=8) and 0.80(95% CI 0.30-2.12, N=4) in never treated. An increased risk was observed in males treated with TNFi (SIR 3.48 95% CI 1.45-8.37) and in ankylosing spondylitis (AS) patients (SIR3.91 95%CI 1.47- 10.42).The SIR for all RA patients was 0.65(95%CI 0.24-1.72). Conclusions: We found no overall association between RA and MS. No overall increased rate of MS was seen in TNFi exposed arthritis patients, but TNFi treated AS and male patients had an increased MS risk. However, low statistical power and diagnostic delay of MS should be taken into consideration when interpreting these results.
Email: lene.dreyer@regionh.dk