{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T04:49:50Z","timestamp":1792039790379,"version":"4.4.0"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"},{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"DOI":"10.13039\/501100003803","name":"University of Hong Kong","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003803","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Drug Saf"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1007\/s40264-026-01687-1","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T10:06:35Z","timestamp":1782468395000},"page":"1435-1451","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety of Biologic and Targeted Synthetic Disease-Modifying Antirheumatic Drugs in Rheumatoid Arthritis: A Longitudinal Analysis"],"prefix":"10.1007","volume":"49","author":[{"given":"Kuan","family":"Peng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent K. C.","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley C. W.","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju-Young","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward Chia\u2011Cheng","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole L.","family":"Pratt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther W. Y.","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chak-sing","family":"Lau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4836-7808","authenticated-orcid":false,"given":"Xue","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"issue":"10","key":"1687_CR1","doi-asserted-by":"publisher","first-page":"e594","DOI":"10.1016\/S2665-9913(23)00211-4","volume":"5","author":"RJ Black","year":"2023","unstructured":"Black RJ, et al. Global, regional, and national burden of rheumatoid arthritis, 1990\u20132020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023;5(10):e594-610. https:\/\/doi.org\/10.1016\/S2665-9913(23)00211-4.","journal-title":"Lancet Rheumatol."},{"issue":"1","key":"1687_CR2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1136\/ard-2022-223356","volume":"82","author":"JS Smolen","year":"2022","unstructured":"Smolen JS, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update. Ann Rheum Dis. 2022;82(1):3. https:\/\/doi.org\/10.1136\/ard-2022-223356.","journal-title":"Ann Rheum Dis"},{"key":"1687_CR3","doi-asserted-by":"publisher","first-page":"343","DOI":"10.2147\/btt.S252575","volume":"15","author":"KE Findeisen","year":"2021","unstructured":"Findeisen KE, Sewell J, Ostor AJK. Biological therapies for rheumatoid arthritis: an overview for the clinician. Biologics. 2021;15:343\u201352. https:\/\/doi.org\/10.2147\/btt.S252575.","journal-title":"Biologics"},{"issue":"5","key":"1687_CR4","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1136\/ard-2022-223762","volume":"82","author":"T Frisell","year":"2023","unstructured":"Frisell T, et al. Safety of biological and targeted synthetic disease-modifying antirheumatic drugs for rheumatoid arthritis as used in clinical practice: results from the ARTIS programme. Ann Rheum Dis. 2023;82(5):601\u201310. https:\/\/doi.org\/10.1136\/ard-2022-223762.","journal-title":"Ann Rheum Dis"},{"issue":"21","key":"1687_CR5","doi-asserted-by":"publisher","first-page":"2331","DOI":"10.1001\/jama.2011.1692","volume":"306","author":"CG Grijalva","year":"2011","unstructured":"Grijalva CG, et al. Initiation of tumor necrosis factor-\u03b1 antagonists and the risk of hospitalization for infection in patients with autoimmune diseases. JAMA. 2011;306(21):2331\u20139. https:\/\/doi.org\/10.1001\/jama.2011.1692.","journal-title":"JAMA"},{"issue":"3","key":"1687_CR6","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1136\/ard-2022-222543","volume":"82","author":"JR Curtis","year":"2023","unstructured":"Curtis JR, et al. Malignancy risk with tofacitinib versus TNF inhibitors in rheumatoid arthritis: results from the open-label, randomised controlled ORAL Surveillance trial. Ann Rheum Dis. 2023;82(3):331\u201343. https:\/\/doi.org\/10.1136\/ard-2022-222543.","journal-title":"Ann Rheum Dis"},{"issue":"10","key":"1687_CR7","doi-asserted-by":"publisher","first-page":"1648","DOI":"10.1002\/art.42250","volume":"74","author":"F Khosrow-Khavar","year":"2022","unstructured":"Khosrow-Khavar F, et al. Tofacitinib and risk of malignancy: results from the Safety of Tofacitinib in Routine Care Patients with Rheumatoid Arthritis (STAR-RA) study. Arthritis Rheumatol. 2022;74(10):1648\u201359. https:\/\/doi.org\/10.1002\/art.42250.","journal-title":"Arthritis Rheumatol"},{"issue":"4","key":"1687_CR8","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1002\/acr.23875","volume":"72","author":"S Singh","year":"2020","unstructured":"Singh S, et al. Comparative risk of cardiovascular events with biologic and synthetic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2020;72(4):561\u201376. https:\/\/doi.org\/10.1002\/acr.23875.","journal-title":"Arthritis Care Res (Hoboken)"},{"issue":"1","key":"1687_CR9","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1136\/ard-2022-223357","volume":"82","author":"A Sepriano","year":"2022","unstructured":"Sepriano A, et al. Safety of synthetic and biological DMARDs: a systematic literature review informing the 2022 update of the EULAR recommendations for the management of rheumatoid arthritis. Ann Rheum Dis. 2022;82(1):107\u201318. https:\/\/doi.org\/10.1136\/ard-2022-223357.","journal-title":"Ann Rheum Dis"},{"issue":"9302","key":"1687_CR10","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1016\/S0140-6736(02)07451-2","volume":"359","author":"DA Grimes","year":"9302","unstructured":"Grimes DA, Schulz KF. Bias and causal associations in observational research. Lancet. 9302;359(9302):248\u201352. https:\/\/doi.org\/10.1016\/S0140-6736(02)07451-2.","journal-title":"Lancet"},{"issue":"1","key":"1687_CR11","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1093\/ckj\/sfab158","volume":"15","author":"NC Chesnaye","year":"2022","unstructured":"Chesnaye NC, et al. An introduction to inverse probability of treatment weighting in observational research. Clin Kidney J. 2022;15(1):14\u201320. https:\/\/doi.org\/10.1093\/ckj\/sfab158.","journal-title":"Clin Kidney J"},{"issue":"5","key":"1687_CR12","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1097\/00001648-200009000-00012","volume":"11","author":"MA Hern\u00e1n","year":"2000","unstructured":"Hern\u00e1n MA, Brumback B, Robins JM. Marginal structural models to estimate the causal effect of zidovudine on the survival of HIV-positive men. Epidemiology. 2000;11(5):561\u201370. https:\/\/doi.org\/10.1097\/00001648-200009000-00012.","journal-title":"Epidemiology"},{"issue":"2","key":"1687_CR13","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1093\/ije\/dyw323","volume":"46","author":"AI Naimi","year":"2017","unstructured":"Naimi AI, Cole SR, Kennedy EH. An introduction to g methods. Int J Epidemiol. 2017;46(2):756\u201362. https:\/\/doi.org\/10.1093\/ije\/dyw323.","journal-title":"Int J Epidemiol"},{"key":"1687_CR14","unstructured":"Hong Kong Hospital Authority. Introduction: caring for our community\u2019s health. Available from: https:\/\/www.ha.org.hk\/visitor\/ha_visitor_index.asp?Content_ID=10008&Lang=ENG&Dimension=100. Accessed 29 Oct 2024."},{"issue":"2","key":"1687_CR15","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/S2215-0366(20)30004-3","volume":"7","author":"Y Chai","year":"2000","unstructured":"Chai Y, et al. Risk of self-harm after the diagnosis of psychiatric disorders in Hong Kong, 2000\u201310: a nested case-control study. Lancet Psychiatry. 2000;7(2):135\u201347. https:\/\/doi.org\/10.1016\/S2215-0366(20)30004-3.","journal-title":"Lancet Psychiatry"},{"issue":"6","key":"1687_CR16","doi-asserted-by":"publisher","first-page":"e2418800","DOI":"10.1001\/jamanetworkopen.2024.18800","volume":"7","author":"K Peng","year":"2024","unstructured":"Peng K, et al. Cost-effectiveness of biosimilars vs leflunomide in patients with rheumatoid arthritis. JAMA Netw Open. 2024;7(6):e2418800. https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.18800.","journal-title":"JAMA Netw Open"},{"key":"1687_CR17","doi-asserted-by":"crossref","unstructured":"Robins JM. Causal inference from complex longitudinal data. In: Latent variable modeling and applications to causality. New York: Springer New York; 1997.","DOI":"10.1007\/978-1-4612-1842-5_4"},{"issue":"2","key":"1687_CR18","doi-asserted-by":"publisher","first-page":"37","DOI":"10.37737\/ace.3.2_37","volume":"3","author":"A Tsuchiya","year":"2021","unstructured":"Tsuchiya A. Introduction to time-dependent confounders and marginal structural models. Ann Clin Epidemiol. 2021;3(2):37\u201344. https:\/\/doi.org\/10.37737\/ace.3.2_37.","journal-title":"Ann Clin Epidemiol."},{"key":"1687_CR19","doi-asserted-by":"publisher","DOI":"10.1177\/1759720x231201047","volume":"15","author":"GA Karpouzas","year":"2023","unstructured":"Karpouzas GA, et al. Rheumatoid arthritis disease activity and adverse events in patients receiving tofacitinib or tumor necrosis factor inhibitors: a post hoc analysis of ORAL Surveillance. Ther Adv Musculoskelet Dis. 2023;15:1759720x231201047. https:\/\/doi.org\/10.1177\/1759720x231201047.","journal-title":"Ther Adv Musculoskelet Dis"},{"issue":"8","key":"1687_CR20","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.1136\/ard-2023-225406","volume":"83","author":"JW Kim","year":"2024","unstructured":"Kim JW, et al. Risk of cardiovascular disease with high-dose versus low-dose use of non-steroidal anti-inflammatory drugs in ankylosing spondylitis. Ann Rheum Dis. 2024;83(8):1028\u201333. https:\/\/doi.org\/10.1136\/ard-2023-225406.","journal-title":"Ann Rheum Dis"},{"issue":"11","key":"1687_CR21","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1136\/ard-2023-224185","volume":"82","author":"H So","year":"2023","unstructured":"So H, et al. Time and dose-dependent effect of systemic glucocorticoids on major adverse cardiovascular event in patients with rheumatoid arthritis: a population-based study. Ann Rheum Dis. 2023;82(11):1387\u201393. https:\/\/doi.org\/10.1136\/ard-2023-224185.","journal-title":"Ann Rheum Dis"},{"issue":"3","key":"1687_CR22","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1007\/s40744-020-00217-4","volume":"7","author":"MN Lwin","year":"2020","unstructured":"Lwin MN, et al. Rheumatoid arthritis: the impact of mental health on disease: a narrative review. Rheumatol Ther. 2020;7(3):457\u201371. https:\/\/doi.org\/10.1007\/s40744-020-00217-4.","journal-title":"Rheumatol Ther."},{"issue":"8","key":"1687_CR23","doi-asserted-by":"publisher","first-page":"2109","DOI":"10.3390\/jcm11082109","volume":"11","author":"SH Nam","year":"2022","unstructured":"Nam SH, et al. Risk of new-onset diabetes mellitus associated with antirheumatic drugs in patients with rheumatoid arthritis: a nationwide population study. J Clin Med. 2022;11(8):2109. https:\/\/doi.org\/10.3390\/jcm11082109.","journal-title":"J Clin Med"},{"issue":"1","key":"1687_CR24","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.rdc.2017.09.005","volume":"44","author":"E Craig","year":"2018","unstructured":"Craig E, Cappelli LC. Gastrointestinal and hepatic disease in rheumatoid arthritis. Rheum Dis Clin North Am. 2018;44(1):89\u2013111. https:\/\/doi.org\/10.1016\/j.rdc.2017.09.005.","journal-title":"Rheum Dis Clin North Am"},{"issue":"1","key":"1687_CR25","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1002\/mpr.329","volume":"20","author":"MJ Azur","year":"2011","unstructured":"Azur MJ, et al. Multiple imputation by chained equations: what is it and how does it work? Int J Methods Psychiatr Res. 2011;20(1):40\u20139. https:\/\/doi.org\/10.1002\/mpr.329.","journal-title":"Int J Methods Psychiatr Res"},{"key":"1687_CR26","unstructured":"World Health Organization. ATC\/DDD Index. 2024. Available from: https:\/\/atcddd.fhi.no\/atc_ddd_index\/. Accessed 29 Oct 2024."},{"issue":"1","key":"1687_CR27","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1111\/j.1541-0420.2011.01656.x","volume":"68","author":"MM Joffe","year":"2012","unstructured":"Joffe MM, Yang WP, Feldman H. G-estimation and artificial censoring: problems, challenges, and applications. Biometrics. 2012;68(1):275\u201386. https:\/\/doi.org\/10.1111\/j.1541-0420.2011.01656.x.","journal-title":"Biometrics"},{"issue":"2","key":"1687_CR28","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185x.70140","volume":"28","author":"K Peng","year":"2025","unstructured":"Peng K, et al. B\/ts DMARDs utilization in the management of rheumatoid arthritis: a descriptive study of a 12-year retrospective cohort in Hong Kong. Int J Rheum Dis. 2025;28(2):e70140. https:\/\/doi.org\/10.1111\/1756-185x.70140.","journal-title":"Int J Rheum Dis"},{"issue":"5","key":"1687_CR29","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1111\/opo.12131","volume":"34","author":"RA Armstrong","year":"2014","unstructured":"Armstrong RA. When to use the Bonferroni correction. Ophthalmic Physiol Opt. 2014;34(5):502\u20138. https:\/\/doi.org\/10.1111\/opo.12131.","journal-title":"Ophthalmic Physiol Opt"},{"issue":"2","key":"1687_CR30","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1177\/0962280208092301","volume":"18","author":"L Meira-Machado","year":"2009","unstructured":"Meira-Machado L, et al. Multi-state models for the analysis of time-to-event data. Stat Methods Med Res. 2009;18(2):195\u2013222. https:\/\/doi.org\/10.1177\/0962280208092301.","journal-title":"Stat Methods Med Res"},{"issue":"3","key":"1687_CR31","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1001\/jama.2012.96867","volume":"309","author":"V Prasad","year":"2013","unstructured":"Prasad V, Jena AB. Prespecified falsification end points: can they validate true observational associations? JAMA. 2013;309(3):241\u20132. https:\/\/doi.org\/10.1001\/jama.2012.96867.","journal-title":"JAMA"},{"issue":"3","key":"1687_CR32","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1097\/EDE.0b013e3181d61eeb","volume":"21","author":"M Lipsitch","year":"2010","unstructured":"Lipsitch M, Tchetgen Tchetgen E, Cohen T. Negative controls: a tool for detecting confounding and bias in observational studies. Epidemiology. 2010;21(3):383\u20138. https:\/\/doi.org\/10.1097\/EDE.0b013e3181d61eeb.","journal-title":"Epidemiology"},{"issue":"5","key":"1687_CR33","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1016\/j.jclinepi.2008.05.015","volume":"62","author":"RA Marrie","year":"2009","unstructured":"Marrie RA, Dawson NV, Garland A. Quantile regression and restricted cubic splines are useful for exploring relationships between continuous variables. J Clin Epidemiol. 2009;62(5):511-7.e1. https:\/\/doi.org\/10.1016\/j.jclinepi.2008.05.015.","journal-title":"J Clin Epidemiol"},{"issue":"4","key":"1687_CR34","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1007\/s10067-015-2879-0","volume":"34","author":"M Backhaus","year":"2015","unstructured":"Backhaus M, et al. Comparison of tocilizumab and tumour necrosis factor inhibitors in rheumatoid arthritis: a retrospective analysis of 1603 patients managed in routine clinical practice. Clin Rheumatol. 2015;34(4):673\u201381. https:\/\/doi.org\/10.1007\/s10067-015-2879-0.","journal-title":"Clin Rheumatol"},{"issue":"12","key":"1687_CR35","doi-asserted-by":"publisher","first-page":"1950","DOI":"10.1136\/annrheumdis-2011-201087","volume":"71","author":"VP Bykerk","year":"2012","unstructured":"Bykerk VP, et al. Tocilizumab in patients with active rheumatoid arthritis and inadequate responses to DMARDs and\/or TNF inhibitors: a large, open-label study close to clinical practice. Ann Rheum Dis. 2012;71(12):1950\u20134. https:\/\/doi.org\/10.1136\/annrheumdis-2011-201087.","journal-title":"Ann Rheum Dis"},{"issue":"2","key":"1687_CR36","doi-asserted-by":"publisher","first-page":"180","DOI":"10.3803\/EnM.2017.32.2.180","volume":"32","author":"S Suh","year":"2017","unstructured":"Suh S, Park MK. Glucocorticoid-induced diabetes mellitus: an important but overlooked problem. Endocrinol Metab. 2017;32(2):180\u20139. https:\/\/doi.org\/10.3803\/EnM.2017.32.2.180.","journal-title":"Endocrinol Metab"},{"issue":"3","key":"1687_CR37","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2023-003045","volume":"9","author":"S Yu-Jih","year":"2023","unstructured":"Yu-Jih S, et al. Disease-modifying anti-rheumatic drugs associated with different diabetes risks in patients with rheumatoid arthritis. RMD Open. 2023;9(3):e003045. https:\/\/doi.org\/10.1136\/rmdopen-2023-003045.","journal-title":"RMD Open"},{"issue":"24","key":"1687_CR38","doi-asserted-by":"publisher","first-page":"2525","DOI":"10.1001\/jama.2011.878","volume":"305","author":"DH Solomon","year":"2011","unstructured":"Solomon DH. Association between disease-modifying antirheumatic drugs and diabetes risk in patients with rheumatoid arthritis and psoriasis. JAMA. 2011;305(24):2525\u201331. https:\/\/doi.org\/10.1001\/jama.2011.878.","journal-title":"JAMA"},{"issue":"4","key":"1687_CR39","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0196368","volume":"13","author":"Y Otsuka","year":"2018","unstructured":"Otsuka Y, et al. Effects of tumor necrosis factor inhibitors and tocilizumab on the glycosylated hemoglobin levels in patients with rheumatoid arthritis; an observational study. PLoS ONE. 2018;13(4):e0196368. https:\/\/doi.org\/10.1371\/journal.pone.0196368.","journal-title":"PLoS ONE"},{"issue":"4","key":"1687_CR40","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1002\/acr2.11124","volume":"2","author":"RJ Desai","year":"2020","unstructured":"Desai RJ, et al. Comparative risk of diabetes mellitus in patients with rheumatoid arthritis treated with biologic or targeted synthetic disease-modifying drugs: a cohort study. ACR Open Rheumatol. 2020;2(4):222\u201331. https:\/\/doi.org\/10.1002\/acr2.11124.","journal-title":"ACR Open Rheumatol"},{"key":"1687_CR41","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1080\/14740338.2016.1240783","volume":"15","author":"S Minozzi","year":"2016","unstructured":"Minozzi S, et al. Risk of infections using anti-TNF agents in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: a systematic review and meta-analysis. Expert Opin Drug Saf. 2016;15:11\u201334. https:\/\/doi.org\/10.1080\/14740338.2016.1240783.","journal-title":"Expert Opin Drug Saf"},{"issue":"4","key":"1687_CR42","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1056\/NEJMoa2109927","volume":"386","author":"R Ytterberg Steven","year":"2022","unstructured":"Ytterberg Steven R, et al. Cardiovascular and cancer risk with tofacitinib in rheumatoid arthritis. N Engl J Med. 2022;386(4):316\u201326. https:\/\/doi.org\/10.1056\/NEJMoa2109927.","journal-title":"N Engl J Med"},{"issue":"12","key":"1687_CR43","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1038\/s41584-023-01037-w","volume":"19","author":"J Brock","year":"2023","unstructured":"Brock J, et al. Immune mechanisms of depression in rheumatoid arthritis. Nat Rev Rheumatol. 2023;19(12):790\u2013804. https:\/\/doi.org\/10.1038\/s41584-023-01037-w.","journal-title":"Nat Rev Rheumatol"},{"issue":"1","key":"1687_CR44","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1001\/2013.jamapsychiatry.4","volume":"70","author":"CL Raison","year":"2013","unstructured":"Raison CL, et al. A randomized controlled trial of the tumor necrosis factor antagonist infliximab for treatment-resistant depression. JAMA Psychiat. 2013;70(1):31\u201341. https:\/\/doi.org\/10.1001\/2013.jamapsychiatry.4.","journal-title":"JAMA Psychiat"},{"issue":"1","key":"1687_CR45","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1038\/s41398-020-01164-y","volume":"11","author":"JM Knight","year":"2021","unstructured":"Knight JM, et al. The IL-6 antagonist tocilizumab is associated with worse depression and related symptoms in the medically ill. Transl Psychiatry. 2021;11(1):58. https:\/\/doi.org\/10.1038\/s41398-020-01164-y.","journal-title":"Transl Psychiatry"},{"issue":"4","key":"1687_CR46","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1007\/s00774-022-01325-7","volume":"40","author":"S Soen","year":"2022","unstructured":"Soen S, et al. Fracture risk associated with glucocorticoid-induced osteoporosis in Japan. J Bone Miner Metab. 2022;40(4):636\u201347. https:\/\/doi.org\/10.1007\/s00774-022-01325-7.","journal-title":"J Bone Miner Metab"}],"container-title":["Drug Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40264-026-01687-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40264-026-01687-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40264-026-01687-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T04:41:46Z","timestamp":1792039306000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40264-026-01687-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,26]]},"references-count":46,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["1687"],"URL":"https:\/\/doi.org\/10.1007\/s40264-026-01687-1","relation":{},"ISSN":["0114-5916","1179-1942"],"issn-type":[{"value":"0114-5916","type":"print"},{"value":"1179-1942","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,26]]},"assertion":[{"value":"12 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Xue Li  received research grants or contracts from the Health and Medical Research Fund (HMRF) Main Scheme and HMRF Fellowship Scheme of the Hong Kong Special Administrative Region (SAR), China, and from the Research Grants Council Early Career Scheme, Research Impact Fund (Hong Kong SAR); was former nonexecutive director of Advanced Data Analytics for Medical Science Limited, Hong Kong SAR, China; received commission grants from Department of Health, Government of Hong Kong SAR, China; commission grants from Hospital Authority of Hong Kong SAR, China, internal funding from the University of Hong Kong, and research or education grants from Pfizer, Janssen and Bristol Myers Squibb (BMS), Novartis; received consultancy fees from Merck Sharp & Dohme, Pfizer, Open Health and The Office of Health Economics; and received honoraria for associate editorship from Nature Springer. None related to the work reported in the current manuscript. Nicole L. Pratt is an Editorial Board member of\n                      Drug Safety\n                      and was not involved in the selection of peer reviewers for the manuscript nor in any of the subsequent editorial decisions.\u00a0Edward Chia\u2011Cheng\u00a0Lai\u00a0reports receiving research funding from Amgen, AbbVie, GW, IQVIA, J&J, MSD, Novartis, Pfizer, Prospection, Sanofi, and Taketa, outside the submitted work. Esther W.Y. Chan has received grants from Research Grants Council (RGC, HKSAR), Research Fund Secretariat of the Food and Health Bureau (Health and Medical Research Fund [HMRF], HKSAR), National Health and Medical Research Council (Australia), Narcotics Division of the Security Bureau of HKSAR, Innovation and Technology Commission of the Government of HKSAR, National Natural Science Fund of China, Amgen, AstraZeneca, Bayer, Bristol Myers Squibb, Eisai, Janssen, Pfizer, Takeda, and Novartis; and honorarium from Pfizer, Novartis, and the Hong Kong SAR Hospital Authority outside the submitted work.\u00a0Kuan Peng, Vincent K.C. Yan, Shirley C.W. Chan, Ju-Young Shin and Chak-sing Lau have no conflicts of interest that are directly relevant to the content of this article.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"We thank Lisa Lam for proofreading this paper, and we thank Dr. Deliang Yang for providing statistical support during the analysis.","order":2,"name":"Ethics","label":"Acknowledgements","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Enhanced Start-up Fund for new academic staff, LKS Faculty of Medicine, The University of Hong Kong,\u00a0The University of Hong Kong Seed Fund for resubmission of General Research Fund, and the Internal Research Fund, Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong provided funding for the preparation of this article.","order":3,"name":"Ethics","label":"Funding","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was performed in accordance with the Declaration of Helsinki (1964) and its subsequent amendments. Ethical approval for the research was granted by the Institutional Review Board of The University of Hong Kong Hospital Authority Hong Kong West Cluster under reference numbers UW 21-338. The institutional review board granted a waiver of informed patient consent. This was justified as the studies were exclusively observational, meaning no practical interventions were administered, and all patient-level data utilised were de-identified by the data custodian at the time of data extraction.","order":4,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":5,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":6,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The data supporting the findings of this study were obtained from the electronic health records database managed by the Hospital Authority of Hong Kong. Owing to data privacy regulations and licensing restrictions, the data cannot be shared publicly. Access to the data may be requested directly from the Hospital Authority of Hong Kong, subject to their approval and compliance with applicable regulations.","order":7,"name":"Ethics","label":"Availability of data and material","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The analytical code supporting this study is publicly available at\n                      \n                      .","order":8,"name":"Ethics","label":"Code availability","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"KP and VKCY performed the data analysis. KP, SCWC and XL conceptualised the study. KP and XL wrote the manuscript. SCWC, NLP, CSL, ECCL,CSL, JYS and EWYC contributed to the interpretation of results. XL supervised the study and obtained funding. All authors reviewed and approved the final manuscript.","order":9,"name":"Ethics","label":"Authors contributions","group":{"name":"EthicsHeading","label":"Declarations"}}]}}