Tumor Necrosis Factor Inhibitor Therapy and The Risk of Developing Depression Among Working-Age Adults with Rheumatoid Arthritis

Deb, Arijita; Dwibedi, Nilanjana; LeMasters, Traci; Hornsby, Jo Ann Allen; Wei, Wenhui; Sambamoorthi, Usha

doi:10.1016/j.jval.2018.04.1303

Cited by 7 publications

(7 citation statements)

References 35 publications

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“…Accordingly, anti-inflammatory effects do not appear to be sufficient for improvements in depression, although they may make some contribution. The possible utility of TNF inhibitors and other immunomodulators in treating depression is suggested by some studies (10,37,38). However, infliximab did not result in overall improvement in treatment-resistant depression in non-RA patients, although it was associated with improved depressive symptoms in the subgroup of patients with high baseline levels of inflammation (39), suggesting that effects on depression are mediated in part through anti-inflammatory activity.…”

Section: Discussionmentioning

confidence: 99%

Characterisation of depressive symptoms in rheumatoid arthritis patients treated with tocilizumab during routine daily care

Behrens

Burmester

Feuchtenberger

et al. 2022

Pathogenesis of Rheumatoid Arthritis: One Year in Review 2022

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ObjectiveTo assess whether tocilizumab treatment is associated with changes in depression symptoms in patients with rheumatoid arthritis (RA) during routine daily care. MethodsWe retrospectively analysed data from a German non-interventional study (ARATA) of adult, tocilizumab-naïve RA patients who initiated subcutaneous tocilizumab and were followed for 52 weeks. The Beck Depression Inventory II (BDI-II) was used to assess symptoms of depression and create baseline subgroups of no (BDI-II<14), mild (14-19), moderate (20-28), and severe (≥29) depression. Other key outcomes included Disease Activity Score-28 joints (DAS28), patient-reported outcomes (PROs), and adverse events. Mixed model repeated measures (MMRM) assessed the impact of DAS28 on BDI-II over time, and Pearson correlation analyses evaluated associations between changes from baseline. ResultsOf 474/1155 ARATA patients who completed the BDI-II at baseline, 47.7% had evidence of depression: 18.4% mild, 17.7% moderate, and 11.6% severe. 229 patients (48.3%) completed the BDI-II at both baseline and week 52. Two-thirds of patients with moderate or severe depression at baseline improved to a milder or no depression subgroup at week 52 (44/65 [67.7%]). Improvements in disease activity and PROs were observed in all subgroups, but patients with depression had lower response and higher adverse events rates. We observed an association between DAS28 and BDI-II over time in MMRM analyses, but the Pearson correlation for change from baseline was weak (r=0.10). Conclusion Depression is common in patients receiving routine care for RA. Improvements in depressive symptoms in RA duringtocilizumab therapy appear to be distinct from changes in disease activity.

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Section: Discussionmentioning

confidence: 99%

Characterisation of depressive symptoms in rheumatoid arthritis patients treated with tocilizumab during routine daily care

Behrens

Burmester

Feuchtenberger

et al. 2022

Pathogenesis of Rheumatoid Arthritis: One Year in Review 2022

View full text Add to dashboard Cite

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“…For example, in RA blockade of systemic TNF has beneficial effects on centrally mediated behaviours including mood. 19 Further, anti-TNF therapy in RA acutely alters fMRI brain activation. 20 21 This aligns with significant overall improvement in well-being, which patients can report often in advance of any objective improvement in their peripheral joint inflammation for example, swollen joints.…”

Section: Discussionmentioning

confidence: 99%

Depression and anxiety in an early rheumatoid arthritis inception cohort. associations with demographic, socioeconomic and disease features

et al. 2020

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ObjectiveDepression and anxiety are not uncommon in Rheumatoid arthritis (RA). It is increasingly recognised that they are associated with high disease activity and worse disease outcomes. We aimed to examine the frequency of depression and anxiety in an early RA inception cohort and to explore associations with disease-related measures.MethodsThe Scottish Early Rheumatoid Arthritis inception cohort recruited newly diagnosed RA patients followed-up 6-monthly. Anxiety and depression were assessed using the hospital anxiety and depression scale. Associations with demographic characteristics and disease-related measures were examined at baseline, 6 months and 12 months.Results848 RA patients were included. The prevalence of anxiety and depression at baseline was 19.0% and 12.2%, respectively. Depression and anxiety scores correlated with DAS28 at all time-points (all p<0.0001). In multivariable linear regression, anxiety score at baseline was associated with younger age and Health Assessment Questionnaire (HAQ) score. Anxiety scores at 6 months and 12 months were associated with low body mass index (BMI), baseline anxiety score and current patient global score and HAQ. Depression score at baseline was associated with younger age, being single and HAQ, while depression scores at 6 months and 12 months were associated with male gender (only at 6 months), baseline anxiety and depression scores and current patient global score, HAQ and C-reactive protein (CRP) levels.ConclusionDepression and anxiety are associated with disease activity, worse functional status and other variables in early RA. There is a close relationship between CRP and depression but not anxiety.

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“…In a Taiwan cross-sectional study, authors found a significantly lower risk of depression among patients receiving etanercept compared with the nonbiologic group . Furthermore, the risk for depression was significantly reduced among patients with RA who responded to TNF-inhibitor therapy compared with those who did not respond to such therapy . Some studies have suggested that the administration of tocilizumab, an anti-IL-6 receptor monoclonal antibody, may improve depression in individuals with RA .…”

Section: Discussionmentioning

confidence: 99%

“… 36 Furthermore, the risk for depression was significantly reduced among patients with RA who responded to TNF-inhibitor therapy compared with those who did not respond to such therapy. 37 Some studies have suggested that the administration of tocilizumab, an anti-IL-6 receptor monoclonal antibody, may improve depression in individuals with RA. 38 , 39 However, in a recent review, Matcham et al 40 argued that relying solely on biologic agents such as bDMARDs and tsDMARDs is unlikely to yield significant improvements in mental health outcomes for patients with RA.…”

Section: Discussionmentioning

confidence: 99%

Rheumatoid Arthritis and Risk of Depression in South Korea

Jeon,

Han,

Jung

et al. 2024

JAMA Netw Open

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ImportanceDepression is among the most common comorbidities in rheumatoid arthritis (RA). There is a lack of data regarding the association of RA seropositivity and biologic agents with depression risk among individuals with RA.ObjectiveTo investigate the risk of depression following RA diagnosis among patients in South Korea.Design, Setting, and ParticipantsThis retrospective cohort study included 38 487 patients with RA and a comparison group of 192 435 individuals matched 1:5 for age, sex, and index date. Data were from the Korean National Health Insurance Service database. Participants were enrolled from 2010 to 2017 and were followed up until 2019. Participants who had previously been diagnosed with depression or were diagnosed with depression within 1 year after the index date were excluded. Statistical analysis was performed in May 2023.ExposuresSeropositive RA (SPRA) was defined with the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes M05 and enrollment in the Korean Rare and Intractable Diseases program. Seronegative RA (SNRA) was defined with ICD-10 codes M06 (excluding M06.1 and M06.4) and a prescription of any disease-modifying antirheumatic drugs (DMARDs) for 270 days or more.Main Outcomes and MeasuresNewly diagnosed depression (ICD-10 codes F32 or F33).ResultsThe mean (SD) age of the total study population was 54.6 (12.1) years, and 163 926 individuals (71.0%) were female. During a median (IQR) follow-up of 4.1 (2.4-6.2) years, 27 063 participants (20 641 controls and 6422 with RA) developed depression. Participants with RA had a 1.66-fold higher risk of depression compared with controls (adjusted hazard ratio [aHR], 1.66 [95% CI, 1.61-1.71]). The SPRA group (aHR, 1.64 [95% CI, 1.58-1.69]) and the SNRA group (aHR, 1.73 [95% CI, 1.65-1.81]) were associated with an increased risk of depression compared with controls. Patients with RA who used biologic or targeted synthetic DMARDs (aHR, 1.33 [95% CI, 1.20-1.47]) had a lower risk of depression compared with patients with RA who did not use these medications (aHR, 1.69 [95% CI, 1.64-1.74]).Conclusions and RelevanceThis nationwide cohort study found that both SPRA and SNRA were associated with a significantly higher risk of depression. These results suggest the importance of early screening and intervention for mental health in patients with RA.

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Tumor Necrosis Factor Inhibitor Therapy and The Risk of Developing Depression Among Working-Age Adults with Rheumatoid Arthritis

Cited by 7 publications

References 35 publications

Characterisation of depressive symptoms in rheumatoid arthritis patients treated with tocilizumab during routine daily care

Characterisation of depressive symptoms in rheumatoid arthritis patients treated with tocilizumab during routine daily care

Depression and anxiety in an early rheumatoid arthritis inception cohort. associations with demographic, socioeconomic and disease features

Rheumatoid Arthritis and Risk of Depression in South Korea

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