The Biological Disease-Modifying Antirheumatic Drugs and the Risk of Cardiovascular Events: A Systematic Review and Meta-Analysis

Table 2

Sensitivity analyses for the use of bDMARD and incidence of heart failure in patients with systemic inflammatory conditions.

Endpoint	Subgroup		Participant (bDMARD/control)	OR	95% CI	value
Heart failure
	Total		32105/30636	0.84	0.74, 0.95	0.006	21
	Study type	Cohort	24511/26848	0.81	0.60, 1.11	0.19	67
		RCT	6725/3248	1.03	0.49, 2.18	0.93	0
	Disease type	RA	28625/28688	0.83	0.73, 0.95	0.006	41
		Ps	869/511	0.78	0.14, 4.33	0.78	0
		SLE	2611/1408	0.98	0.40, 2.42	0.96	0
	Drug type	TNF-α inhibitor	27786/28274	0.83	0.73, 0.95	0.005	43
		IL-23 inhibitor	294/98	1.01	0.04, 24.92	1.00	NA
		IL-6 receptor inhibitor	1158/574	2.49	0.29, 21.35	0.41	0
		B cell inhibition	2233/1126	0.97	0.34, 2.72	0.95	0
		T cell inhibition	454/353	1.00	0.15, 6.61	1.00	0
		IFN receptor antibody	180/182	0.34	0.01, 8.28	0.50	NA
	Follow-up duration	>1 year	18357/20935	0.80	0.69, 0.93	0.003	38
		<1 year	13748/9672	0.99	0.75, 1.30	0.93	0
	Previous CVD	<30%	17575/175/73	0.95	0.77, 1.17	0.62	38
		30-50%	169/88	2.64	0.13, 55.63	0.53	NA
		>50%	225/808	1.20	0.79, 1.84	0.39	NA
	Diabetes	<30%	15647/12092	0.69	0.35, 1.36	0.28	72
		30-50%	1002/4591	1.10	0.81, 1.49	0.53	0
	Hypertension	30-50%	15116/11549	0.83	0.53, 1.28	0.39	59
		>50%	1002/4591	1.10	0.81, 1.49	0.53	0
	Dyslipidemia	>50% (all available studies)	12589/13276	1.04	0.84, 1.28	0.71	0

Previous cardiovascular disease includes ischemia heart disease, coronary heart disease, angina, myocardial infarction, congestive heart failure, atrial fibrillation, and cerebrovascular disease. bDMARD: biological disease-modifying antirheumatic drug; CVD: cardiovascular disease; IFN: interferon; IL: interleukin; MACE: major adverse cardiovascular event; NA: not applicable; Ps: psoriasis; RCT: randomized controlled trial; RA: rheumatoid arthritis; SLE: systemic lupus erythematosus; TNF: tumor necrosis factor.