2 vs. 4.1, P < 0.05). However, this difference represents a standardized effect (d) of 0.08 standard deviations, less than half of the conventional threshold d = 0.20 for a ‘small’ effect.[32] The baseline characteristics after 1 : 2 (bDMARD : tDMARD) propensity score-matching of patients treated with either etanercept or adalimumab as selleck chemical first-line therapy are shown in Table 2. Most patients were female (> 80%), had been treated with approximately four different tDMARDs and had similar comorbidity profiles. The number of cases and the adverse event

incidence rate per 100 000 patient years for the bDMARD and tDMARD cohorts are shown in Table 3. An adverse event endpoint occurred in 2721 patients. After applying the event attribution algorithm, 1972 out of 11 347 (7888 tDMARD, 3459 bDMARD) patients had events that occurred in time periods that were eligible for analysis. SBIs were the most common adverse events across all cohorts (1711 events), followed by TB (406) and lymphoma (33). A nominally higher incidence rate per 100 000 patient years (95% CI) occurred in the bDMARD versus tDMARD cohort for each adverse endpoint: SBI, 3068 (2677–3499) versus 2956 (2807–3109);

TB, 1458 (1196–1761) versus 546 (486–612); lymphoma, 133 (64–245) versus 41 (26–62). The IRR (95% CI) estimates showed elevated risk among bDMARD users of 2.67 (2.12–3.34) for TB and 3.24 (1.37–7.06) for lymphoma. The IRR for SBI did not reach significance (1.04, 95% CI 0.89–1.19). A total of 164 patients out of the 2238 matched Gefitinib in vitro etanercept and adalimumab patients had at least one adverse event. All events Inositol monophosphatase 1 were eligible for analysis after applying the attribution algorithm. The number of events, incidence rate per 100 000 patient years, and the IRR comparisons of adalimumab versus etanercept are shown in Table 4. Among the matched adalimumab and etanercept patients,

there were a total of 116 SBIs, 58 TB events, and four lymphoma events. For SBI, the incidence rate for the adalimumab group was 4967 (3441–6940), higher than incidence rate of 2708 (2154–3362) in the etanercept group. The SBI IRR for adalimumab-treated patients was 1.83 (1.19–2.77). The incidence rate of TB for the adalimumab group was 2888 (1764–4461); this was higher than the incidence rate of 1228 (869–1685) in the etanercept group. The IRR (95% CI) for TB in the adalimumab group was 2.35 (1.29–4.15). The incidence rate of lymphoma was 144 (4–800) and 96 (20–280) in the adlimumbab and etanercept groups, respectively. The IRR (95% CI) for lymphoma in the adalimumab group was 1.49 (0.03–18.66), suggesting no difference in risk compared with etanercept. Results from this study showed a higher risk for tuberculosis and lymphoma in patients receiving bDMARDs compared with patients receiving tDMARDS, but not for SBI.