{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T20:31:10Z","timestamp":1792528270280,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T00:00:00Z","timestamp":1766275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T00:00:00Z","timestamp":1766275200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>\n                    Tumor necrosis factor\u2010\u03b1 inhibitors (TNF\u03b1i) and Janus kinase inhibitors (JAKi) are widely used biologic and targeted synthetic disease\u2010modifying antirheumatic drugs (b\/tsDMARDs) for rheumatoid arthritis. We aimed to compare the risk of serious infections between TNF\u03b1i and JAKi in patients with rheumatoid arthritis. We conducted a retrospective cohort study using a nationwide Japanese claims database covering over 19\u2009million individuals. Patients were identified using the International Classification of Diseases, 10th Revision (ICD\u201010) codes (M05 or M06), and new users of bDMARDs or JAKi were included. We applied overlap weighting based on propensity scores. The primary outcome was serious infection, defined as a hospitalization\u2010associated infection accompanied by diagnostic testing or anti\u2010infective treatment. Among 5,018 eligible rheumatoid arthritis patients (TNF\u03b1i: 4042; JAKi: 976), TNF\u03b1i use was associated with a significantly lower risk of serious infections (HR: 0.55; 95% confidence interval: 0.39\u20130.77). The\n                    <jats:italic>E<\/jats:italic>\n                    \u2010value for the observed HR was 2.39, suggesting that unmeasured confounding would need to be strongly associated with both treatment assignment and infection risk to fully explain the result. Site\u2010specific analyses showed significantly lower risks of respiratory tract infections, urogenital infections, and sepsis in the TNF\u03b1i group. Drug\u2010specific analyses indicated an elevated infection risk with baricitinib and infliximab. In this study, TNF\u03b1i use was associated with a lower risk of serious infections than JAKi in patients with rheumatoid arthritis. These findings support the preferential use of TNF\u03b1i in infection\u2010prone populations and highlight the importance of individualized risk assessment in rheumatoid arthritis treatment decisions.\n                  <\/jats:p>","DOI":"10.1002\/cpt.70172","type":"journal-article","created":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T15:50:22Z","timestamp":1766332222000},"page":"1307-1316","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Serious Infection Risk With\n                    <scp>TNF<\/scp>\n                    Inhibitors vs.\n                    <scp>JAK<\/scp>\n                    Inhibitors in Rheumatoid Arthritis: A Nationwide Claims\u2010Based Cohort Study"],"prefix":"10.1002","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0161-6766","authenticated-orcid":false,"given":"Ryosuke","family":"Ota","sequence":"first","affiliation":[{"name":"Department of Pharmacy Kindai University Nara Hospital  Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4865-3807","authenticated-orcid":false,"given":"Atsushi","family":"Hirata","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Kindai University Nara Hospital  Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5894-3552","authenticated-orcid":false,"given":"Takeo","family":"Hata","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Osaka Medical and Pharmaceutical University Hospital  Osaka Japan"},{"name":"Department of Medical Informatics Osaka Medical and Pharmaceutical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shumpei","family":"Takatsu","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics Osaka Medical and Pharmaceutical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Iguchi","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics Osaka Medical and Pharmaceutical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7976-2750","authenticated-orcid":false,"given":"Masami","family":"Nishihara","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Osaka Medical and Pharmaceutical University Hospital  Osaka Japan"},{"name":"Department of Hospital Quality and Safety Management Osaka Medical and Pharmaceutical University Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5972-946X","authenticated-orcid":false,"given":"Akira","family":"Ashida","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Osaka Medical and Pharmaceutical University Hospital  Osaka Japan"},{"name":"Department of Pediatrics, Faculty of Medicine Osaka Medical and Pharmaceutical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,21]]},"reference":[{"key":"e_1_2_10_1_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2016.200"},{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/mr\/roac017"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22783"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210715"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/25785826.2020.1770948"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.10524"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kew502"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/mr\/road031"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-024-06980-x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kead198"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-023-03111-w"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwg231"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.37737\/ace.22004"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h2809"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1692"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22600"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.2016.1260466"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/03610910902859574"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2011.568786"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2009.00671.x"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2607"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38745"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1089\/1079990041689665"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa895"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2024.1376262"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0306548"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/mr\/roac001"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.10529"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes305"}],"container-title":["Clinical 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