{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T18:08:21Z","timestamp":1761156501042,"version":"build-2065373602"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T00:00:00Z","timestamp":1553731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100002429","name":"Amgen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002429","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine disease\u2010modifying antirheumatic drug (<jats:styled-content style=\"fixed-case\">DMARD<\/jats:styled-content>) treatments and estimate the risk of a subsequent cardiovascular (<jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content>) event following an initial <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> event in patients with rheumatoid arthritis (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>), psoriatic arthritis (PsA), or psoriasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed data from MarketScan claims databases (January 1, 2006 to June 30, 2015) for adults with <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>, PsA, or psoriasis and an initial\/index <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> event (acute myocardial infarction, stroke, or coronary revascularization) while receiving <jats:styled-content style=\"fixed-case\">DMARD<\/jats:styled-content>s (tumor necrosis factor inhibitor [<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>i] biologic <jats:styled-content style=\"fixed-case\">DMARD<\/jats:styled-content>s [<jats:styled-content style=\"fixed-case\">bDMARD<\/jats:styled-content>s], conventional synthetic <jats:styled-content style=\"fixed-case\">DMARD<\/jats:styled-content>s [cs<jats:styled-content style=\"fixed-case\">DMARD<\/jats:styled-content>s], or non\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>i <jats:styled-content style=\"fixed-case\">bDMARD<\/jats:styled-content>s). We studied <jats:styled-content style=\"fixed-case\">DMARD<\/jats:styled-content> treatment patterns following the index event and rates of subsequent <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> events. We used Cox regression to investigate predictors of <jats:styled-content style=\"fixed-case\">DMARD<\/jats:styled-content> discontinuation and risk factors for subsequent <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 10,254 patients, 15.3% discontinued and 15.5% switched <jats:styled-content style=\"fixed-case\">DMARD<\/jats:styled-content> therapy after the index <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> event. Independent predictors of <jats:styled-content style=\"fixed-case\">DMARD<\/jats:styled-content> discontinuation included a psoriasis diagnosis, renal disease, hypertension, heart failure, diabetes mellitus, older age, and baseline cs<jats:styled-content style=\"fixed-case\">DMARD<\/jats:styled-content> or non\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>i <jats:styled-content style=\"fixed-case\">bDMARD<\/jats:styled-content> use (versus <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>i <jats:styled-content style=\"fixed-case\">bDMARD<\/jats:styled-content>s). Rates per 1,000 patient\u2010years of subsequent events were 75.2 (95% confidence interval [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 54.4\u201396.0) for patients taking <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>i <jats:styled-content style=\"fixed-case\">bDMARD<\/jats:styled-content>s, 83.6 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 53.3\u2013113.9) for cs<jats:styled-content style=\"fixed-case\">DMARD<\/jats:styled-content>s, and 122.4 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 60.6\u2013184.3) for non\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>i <jats:styled-content style=\"fixed-case\">bDMARD<\/jats:styled-content>s. A diagnosis of <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> (versus psoriasis) and heart failure at baseline, but not a <jats:styled-content style=\"fixed-case\">DMARD<\/jats:styled-content> pattern after the index event, were independently associated with an increased risk of subsequent <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> event.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this large nationwide study, nearly one\u2010third of patients with <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>, PsA, or psoriasis switched or discontinued <jats:styled-content style=\"fixed-case\">DMARD<\/jats:styled-content> therapy following a <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> event. There was no association between <jats:styled-content style=\"fixed-case\">DMARD<\/jats:styled-content> class and the risk of a subsequent <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> event.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23609","type":"journal-article","created":{"date-parts":[[2018,5,25]],"date-time":"2018-05-25T08:35:13Z","timestamp":1527237313000},"page":"512-520","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Subsequent Cardiovascular Events Among Patients With Rheumatoid Arthritis, Psoriatic Arthritis, or Psoriasis: Patterns of Disease\u2010Modifying Antirheumatic Drug Treatment"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5556-4618","authenticated-orcid":false,"given":"Jeffrey A.","family":"Sparks","sequence":"first","affiliation":[{"name":"Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamara","family":"Lesperance","sequence":"additional","affiliation":[{"name":"DOCS Global Inc.  North Wales Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil A.","family":"Accortt","sequence":"additional","affiliation":[{"name":"Amgen Inc.  Thousand Oaks California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel H.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,3,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2017.96"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000007308"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-017-1358-1"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-308634"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-205675"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23171"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2016.05.012"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-09-0274"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1759720X15591801"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-307838"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22752"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kew502"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22642"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39198"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39480"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39573"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.02.039"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2011.06.054"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20371"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2015-000080"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-016-8560-9"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1707914"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar3260"},{"volume-title":"Modern epidemiology","year":"2008","author":"Rothman KJ","key":"e_1_2_8_25_1"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.037978"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211608"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.110318"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-207719"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-138-10-200305200-00008"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23281"},{"key":"e_1_2_8_32_1","unstructured":"Immunex Corporation.Enbrel (etanercept): highlights of prescribing information.2016. 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