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T. Kurth, A. M. Walker, R. J. Glynn, K. A. Chan, J. M. Gaziano, K. Berger, et al., “Results of Multivariable Logistic Regression, Propensity Matching, Propensity Adjustment, and Propensity-Based Weighting under Conditions of Nonuniform Effect,” American Journal of Epidemiology, 163, 3, 2006, pp. 262-270. doi:10.1093/aje/kwj047

has been cited by the following article:

• TITLE: TNF-α Antagonist and Infection in Rheumatoid Arthritis

  AUTHORS: Julia F. Simard, Murray A. Mittleman, Nancy A. Shadick, Elizabeth W. Karlson

  KEYWORDS: Inverse Probability Weighting; Anti-TNF; Infection; Rheumatoid Arthritis

  JOURNAL NAME: Open Journal of Rheumatology and Autoimmune Diseases, Vol.2 No.2, May 7, 2012

  ABSTRACT: Background: Anti-TNF treatment may increase infection risk, although this has been difficult to study because the timing of anti-TNF treatment is driven by disease activity, which may influence infection susceptibility leading to confounding that varies over time. We evaluated the association between anti-TNF initiation in rheumatoid arthritis (RA) patients on disease modifying anti-rheumatic drugs (DMARD) and infection using multiple approaches adjusting for time-varying confounding. Methods: 383 anti-TNF-na?ve RA patients on ≥ 1 non-biologic-DMARD at enrollment from the Brigham and Women’s Rheumatoid Arthritis Sequential Study (BRASS) were followed up to two years. Pooled logistic regressions estimated the association between anti-TNF and infection by including time-varying covariates in the adjusted models and inverse probability treatment weighting (IPTW). Results: Adjustment for time-varying disease activity and other suspected confounders yielded non-statistically significant positive associations between anti-TNF start and infection regardless of analytic approach (RRmvar_adj = 2.1, 95% CI: 0.8 - 5.8). Conclusions: Incorporating changing clinical status, and treatment indications and consequences, yielded consistently (though not significantly) elevated relative risks of infection associated with anti-TNF initiation. Due to limited statistical power, we cannot draw firm conclusions. However, we have illustrated multiple approaches adjusting for potential time-varying confounding in longitudinal studies and hope to replicate the approaches in larger studies.