Different Drugs, Same Death Rates

Rheumatoid arthritis patients taking different TNF inhibitors had similar rates of death

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) When it comes to treating rheumatoid arthritis, there are a number of drugs that can be used. Each drug works differently and has different risks. Do these differences also mean different death rates?

The answer may be 'no,' according to a recent study.

Death rates were about the same for patients taking three different arthritis drugs.

The researchers looked at three drugs: Enbrel (etanercept), Remicade (infliximab) or Humira (adalimumab). They found no significant differences in the overall death rates among patients taking these drugs.

When comparing Remicade to Enbrel, the hazard ratio for death was 1.1.

"Work with a doctor to find the best arthritis Rx for you."

For their study, Julia F. Simard, ScD, of Karolinska Institutet in Sweden, and colleagues set out to see if different TNF inhibitors (a class of drugs used to treat rheumatoid arthritis) were associated with different risks of death.

A hazard ratio explains how much an event happens in one group versus another. A hazard ratio of greater than 1.0 means the event happens more in the first group than in the second.

In this case, the event being examined was death.

Even though the hazard ratio for Remicade versus Enbrel was more than 1.0, the difference was not significant.

The situation was similar for the comparison between Humira and Enbrel. The hazard ratio for death among Humira users was 1.3 - another insignificant difference.

It is unclear whether the deaths in this study were directly linked to the drugs patients were taking.

According to the authors, more research is needed to see if specific groups of patients taking TNF inhibitors are at increased risk of death.

The current study included 6,322 patients with rheumatoid arthritis taking TNF inhibitors.

Over the course of the study, 211 patients died. The vast majority (85 percent) of these deaths happened to patients who had taken only one TNF inhibitor.

The study was published October 27 in Arthritis & Rheumatism, a journal of the American College of Rheumatology.

The research was funded by the Swedish Foundation for Strategic Research and Combine, the Swedish national public-private research consortium and the Strategic Research Program in Epidemiology at Karolinska Institutet.

Two of the study's authors reported receiving honoraria or fees from Pfizer, Merck, Abbott Laboratories and Bristol-Myers Squibb.

Humira is manufactured by Abbott. Enbrel is manufactured by Pfizer and Amgen. Remicade is manufactured by Centocor Pharmaceuticals. 

Reviewed by: 
Review Date: 
October 30, 2012
Last Updated:
November 8, 2012