Analysis and visualization of the course and burden over time of adverse drug reactions (ADRs) attributed to TNFα-inhibitors in patients with inflammatory rheumatic diseases (IRDs)

Merel de Boer*, Helen R. Gosselt, Jurriaan Jansen, Martijn B.A. van Doorn, Frank Hoentjen, Michael T. Nurmohamed, Phyllis I. Spuls, Sander W. Tas, Harald E. Vonkeman, Naomi T. Jessurun

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    2 Citations (Scopus)
    22 Downloads (Pure)

    Abstract

    Background: We aimed to investigate course and burden over time of ADRs attributed to TNFα-inhibitors in IRD-patients, and whether Sankey diagrams and polar plots can visualize this. Research design and methods: Data on ADRs experienced during the Dutch Biologic Monitor (January 2017 till December 2022) were used in this study. We selected IRD-patients using a TNFα-inhibitor, reporting skin reactions/infections/injection site reactions and completing ≥3 questionnaires (i.e. the initial report and ≥2 follow-ups). Course was scored as worsening/improving/remaining stable/resolving and as (non-)recurrent. Patients scored burden from 1 (no burden) to 5 (very high burden). Sankey diagrams and polar plots visualized this. Results: 202 patients were included, reporting 353 ADRs. Most skin reactions were stable (25.0%). Most infections resolved (50.8%). Injection site reactions were mostly recurrent (72.3%). Skin reactions and infections tended to decrease in burden. Infections had highest burden at start, which mostly decreased over time. Injection site reactions had a low and stable burden. Conclusions: Skin reactions attributed to TNFα-inhibitors by IRD-patients are stable with a slightly decreasing burden over time. Infections have highest burden at start but resolved mostly. Injection site reactions have a low and stable burden. Sankey diagrams and polar plots are suitable to visualize this.

    Original languageEnglish
    Pages (from-to)195-202
    JournalExpert opinion on drug safety
    Volume22
    Issue number3
    Early online date10 Aug 2022
    DOIs
    Publication statusPublished - 4 Mar 2023

    Keywords

    • Adverse drug reaction
    • burden
    • course
    • polar plots
    • Sankey diagrams
    • n/a OA procedure

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