{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:51:44Z","timestamp":1786978304633,"version":"build-2736575974"},"reference-count":59,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,27]],"date-time":"2025-07-27T00:00:00Z","timestamp":1753574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100002491","name":"Bristol-Myers Squibb","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002491","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine the comparative risk of malignancy, venous thromboembolism (VTE), and heart failure (HF) associated with biologic\/targeted synthetic disease\u2010modifying antirheumatic drugs (b\/ts DMARDs) in patients with rheumatoid arthritis\u00a0(RA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an observational cohort study using 3 US insurance claims databases: Medicare (2009\u20132019), MarketScan (2009\u20132020), and Optum's de\u2010identified Clinformatics Data Mart Database (CDM, 2009\u20132022). We included adults with RA initiating abatacept (reference), tumor necrosis factor inhibitors (TNFi), rituximab, interleukin\u20106 inhibitors (IL\u20106i), or Janus kinase inhibitors (JAKi). We used an as\u2010treated approach as the primary analysis to estimate outcome incidence. Inverse probability of treatment weighting was applied to adjust for confounding. Database\u2010specific hazard ratios (HR) with 95% confidence intervals (CI) were estimated using Cox\u2010proportional hazard models, then combined through random\u2010effects meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 26\u2009908 abatacept, 11\u2009176 IL\u20106i, 115\u2009437 TNFi, 14\u2009045 JAKi, and 12\u2009097 rituximab initiators. Weighted HR (95% CI) of malignancy was 0.73 (0.60\u20130.88) for IL\u20106i, 0.85 (0.60\u20131.19) for JAKi, 1.30 (1.14\u20131.49) for rituximab, and 0.93 (0.85\u20131.02) for TNFi, compared to abatacept. Weighted HR (95% CI) for VTE was 0.92 (0.62\u20131.35), 1.17 (0.73\u20131.86), 1.43 (1.50\u20131.95), and 1.16 (0.93\u20131.46), respectively. Weighted HR (95% CI) for HF was 1.00 (0.69\u20131.46), 1.24 (0.62\u20132.51), 1.52 (1.04\u20132.22), and 1.54 (1.22\u20131.94), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We observed increased risks of malignancy, VTE, and HF among rituximab initiators; an increased risk of HF among TNFi initiators; and a lower risk of malignancy among IL\u20106i initiators, all compared to abatacept initiators. These findings should be interpreted with caution due to the potential influence of residual confounding.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70193","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T02:43:30Z","timestamp":1753670610000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparative Safety of Biologic and Targeted\u2010Synthetic\n                    <scp>DMARDs<\/scp>\n                    in Patients With Rheumatoid Arthritis: A Multi\u2010Database Real\u2010World Cohort Study"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1397-3106","authenticated-orcid":false,"given":"Yinzhu","family":"Jin","sequence":"first","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts 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