{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:20:06Z","timestamp":1789194006356,"version":"build-2803163510"},"reference-count":43,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T00:00:00Z","timestamp":1677542400000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005416","name":"Research Council of Norway","doi-asserted-by":"crossref","award":["project 328657"],"award-info":[{"award-number":["project 328657"]}],"id":[{"id":"10.13039\/501100005416","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001858","name":"VINNOVA","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001858","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014034","name":"Foundation for Research in Rheumatology","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100014034","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004785","name":"NordForsk","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004785","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"crossref","award":["OP0060"],"award-info":[{"award-number":["OP0060"]}],"id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the Swedish Research Council, the Swedish Heart Lung Foundation"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2023,2,12]]},"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To compare incidences of neuroinflammatory events, including demyelinating disease (DML), inflammatory polyneuropathies (IPN) and multiple sclerosis (MS), in patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA; including psoriatic arthritis) starting a tumour necrosis factor inhibitor (TNFi), investigating whether monoclonal TNFi antibodies (other TNFis (oTNFis)) confer higher risk than etanercept.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This is an observational cohort study including patients from the five Nordic countries starting a TNFi in 2001\u20132020. Time to first neuroinflammatory event was identified through register linkages. We calculated crude incidence rates (cIR) per 1000 person-years and used multivariable-adjusted Cox regression to compare incidences of neuroinflammatory events overall and for DML, IPN and MS with oTNFi versus etanercept. We further examined individual TNFis and indications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>33 883 patients with RA and 28\u2009772 patients with SpA were included, initiating 52\u2009704 and 46\u2009572 treatment courses, respectively. In RA, we observed 135 neuroinflammatory events (65% DML) with cIR of 0.38 with oTNFi and 0.34 with etanercept. The HR of oTNFi versus etanercept was 1.07 (95% CI 0.74 to 1.54) for any neuroinflammatory event, 0.79 (95% CI 0.51 to 1.22) for DML, 2.20 (95% CI 1.05 to 4.63) for IPN and 0.73 (95% CI 0.34 to 1.56) for MS. In SpA, we observed 179 events (78% DML) with cIR of 0.68 with oTNFi and 0.65 with etanercept. The HR for any neuroinflammatory event, DML, IPN and MS was 1.06 (95% CI 0.75 to 1.50), 1.01 (95% CI 0.68 to 1.50), 1.28 (95% CI 0.61 to 2.69) and 0.94 (95% CI0.53 to 1.69), respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The cIRs of neuroinflammatory events are higher in SpA than in RA, but the choice of specific TNFi does not seem to play an important role in the risk of neuroinflammatory events.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2022-002924","type":"journal-article","created":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T11:00:21Z","timestamp":1677582021000},"page":"e002924","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Exposure to specific tumour necrosis factor inhibitors and risk of demyelinating and inflammatory neuropathy in cohorts of patients with inflammatory arthritis: a collaborative observational study across five Nordic rheumatology registers"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2716-5679","authenticated-orcid":false,"given":"Benedicte","family":"Delcoigne","sequence":"first","affiliation":[{"name":"Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tine Iskov","family":"Kopp","sequence":"additional","affiliation":[{"name":"Department of Neurology, Copenhagen University Hospital, Kobenhavn, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3677-9736","authenticated-orcid":false,"given":"Elizabeth V","family":"Arkema","sequence":"additional","affiliation":[{"name":"Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7149-0973","authenticated-orcid":false,"given":"Karin","family":"Hellgren","sequence":"additional","affiliation":[{"name":"Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5442-902X","authenticated-orcid":false,"given":"Sella Aarrestad","family":"Provan","sequence":"additional","affiliation":[{"name":"Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway"},{"name":"Department of Public Health and Sport Sciences, Inland Norway University of Applied Sciences, Elverum, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heikki","family":"Relas","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalle","family":"Aaltonen","sequence":"additional","affiliation":[{"name":"ROB-FIN, Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Trokovic","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4631-6505","authenticated-orcid":false,"given":"Bjorn","family":"Gudbjornsson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University Hospital of Iceland, Reykjavik, Iceland"},{"name":"Department of Rheumatology, Centre for Rheumatology Research, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerdur","family":"Grondal","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Research, Landspitali University Hospital, Reykjavik, Iceland"},{"name":"Faculty of Medicine, University of Iceland, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eirik","family":"Klami Kristianslund","sequence":"additional","affiliation":[{"name":"Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesper","family":"Lindhardsen","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Rigshospitalet, Copenhagen University, Copenhague, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lene","family":"Dreyer","sequence":"additional","affiliation":[{"name":"Center of Rheumatic Research Aalborg (CERRA), Aalborg 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