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  1. Article ; Online: Assessing the safety of new drugs during pregnancy.

    Hyrich, K L

    The British journal of dermatology

    2018  Volume 178, Issue 1, Page(s) 18–19

    MeSH term(s) Abnormalities, Drug-Induced ; Biological Therapy ; Drug-Related Side Effects and Adverse Reactions ; Female ; Humans ; Pregnancy
    Language English
    Publishing date 2018-01-23
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 80076-4
    ISSN 1365-2133 ; 0007-0963
    ISSN (online) 1365-2133
    ISSN 0007-0963
    DOI 10.1111/bjd.16057
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  2. Article ; Online: Malignancy and rheumatoid arthritis: Epidemiology, risk factors and management.

    De Cock, Diederik / Hyrich, Kimme

    Best practice & research. Clinical rheumatology

    2019  Volume 32, Issue 6, Page(s) 869–886

    Abstract: Rheumatoid arthritis (RA) is a chronic inflammatory condition that can result in pain and functional disability. It is also associated with an increased occurrence of comorbidities, including an increased risk of certain cancers such as lung cancer and ... ...

    Abstract Rheumatoid arthritis (RA) is a chronic inflammatory condition that can result in pain and functional disability. It is also associated with an increased occurrence of comorbidities, including an increased risk of certain cancers such as lung cancer and lymphoma. The aetiopathogenesis of this increased cancer risk is likely multifactorial and includes shared risk factors as well as chronic inflammation. There is also a concern that the treatment for RA itself may increase this risk further, particularly treatment with biologic disease-modifying anti-rheumatic drugs (DMARDs). This paper aims to review the evidence for the increased risk of cancer in RA as well as the latest evidence for the association between DMARDs and tumorigenesis. It also discusses the evidence for the management of patients with biologic DMARDs in the setting of existing cancer.
    MeSH term(s) Antirheumatic Agents/pharmacology ; Antirheumatic Agents/therapeutic use ; Arthritis, Rheumatoid/epidemiology ; Arthritis, Rheumatoid/pathology ; Arthritis, Rheumatoid/therapy ; Humans ; Neoplasms/etiology ; Neoplasms/pathology ; Risk Factors
    Chemical Substances Antirheumatic Agents
    Language English
    Publishing date 2019-04-15
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2052323-3
    ISSN 1532-1770 ; 1521-6942
    ISSN (online) 1532-1770
    ISSN 1521-6942
    DOI 10.1016/j.berh.2019.03.011
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  3. Article ; Online: Prediction of infection risk in rheumatoid arthritis patients treated with biologics: are we any closer to risk stratification?

    Jani, Meghna / Barton, Anne / Hyrich, Kimme

    Current opinion in rheumatology

    2019  Volume 31, Issue 3, Page(s) 285–292

    Abstract: Purpose of review: There are currently several available biologics for rheumatoid arthritis (RA) with similar efficacy in most trials. A major consideration therefore in choosing a biologic, continues to be safety concerns such as infection. ... ...

    Abstract Purpose of review: There are currently several available biologics for rheumatoid arthritis (RA) with similar efficacy in most trials. A major consideration therefore in choosing a biologic, continues to be safety concerns such as infection. Considerable advances have been made in the understanding of biologic safety on a population level; however, how close are we to stratifying risk for individual patients? This review discusses evidence published in the last year, with reference to key previous literature.
    Recent findings: Comparative safety of biologics has been studied in observational cohorts, with a possible increased risk of serious infection in tocilizumab-treated patients compared with etanercept. Rheumatoid arthritis patients on biologics are often on concomitant medications such as steroids and opioids, and the advances in relation to infection are summarized. Pharmacological biomarkers and optimizing existing risk prediction scores may allow better future risk stratification.
    Summary: Improved quantification of personalized benefit:harms would allow better-informed decisions, reduction of infection-associated morbidity as well as direct/indirect costs associated with biologics. Although advances have been made to better understand and predict risk, future studies are likely to require a range of novel data sources and methodologies for the goal of precision medicine to be truly realized.
    MeSH term(s) Antirheumatic Agents/therapeutic use ; Arthritis, Rheumatoid/drug therapy ; Biological Products/therapeutic use ; Etanercept/therapeutic use ; Humans ; Infections/diagnosis ; Risk Assessment
    Chemical Substances Antirheumatic Agents ; Biological Products ; Etanercept (OP401G7OJC)
    Language English
    Publishing date 2019-02-21
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1045317-9
    ISSN 1531-6963 ; 1040-8711
    ISSN (online) 1531-6963
    ISSN 1040-8711
    DOI 10.1097/BOR.0000000000000598
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  4. Article ; Online: Demyelinating Events Following Initiation of Anti-TNFα Therapy in the British Society for Rheumatology Biologics Registry in Rheumatoid Arthritis.

    Taylor, Thomas R P / Galloway, James / Davies, Rebecca / Hyrich, Kimme / Dobson, Ruth

    Neurology(R) neuroimmunology & neuroinflammation

    2021  Volume 8, Issue 3

    Abstract: Objective: To establish the incidence of demyelination in patients who have received anti-tumor necrosis factor alpha (anti-TNFα) therapy, through analysis of adverse events reported in a prospective cohort of patients receiving biological therapies.: ...

    Abstract Objective: To establish the incidence of demyelination in patients who have received anti-tumor necrosis factor alpha (anti-TNFα) therapy, through analysis of adverse events reported in a prospective cohort of patients receiving biological therapies.
    Methods: A cohort study was performed on prospectively acquired data via the British Society for Rheumatology Biologics Register in Rheumatoid Arthritis. All potential demyelinating events during follow-up were extracted and classified as definite, probable, or possible blinded to treatment data. The point of starting an anti-TNF therapy in individuals with no prior reported demyelination was the time of exposure. Crude rates of demyelination and standardized incident rates (SIRs) compared with the general UK population were calculated.
    Results: Thirty-five individuals with demyelinating events were identified from a total pool of 13,489. The median age at study entry was 44 years, and the median disease duration was 8 years; 71% were female. Events occurred a median of 3 (interquartile range 1-5) years from the start of the first anti-TNF therapy. Twenty-six events occurred in individuals still taking anti-TNFα therapy; of the other 9, 6 were within 90 days of drug withdrawal. The raw incidence of demyelination was 19.7/100,000 patient-years (95% CI 13.7-27.3). The SIR in the whole population was 1.38 (95% CI 0.96-1.92) and 0.83 (0.51-1.26) limited to definite/probable cases.
    Conclusions: Demyelination following anti-TNF therapy is uncommon. Patients receiving anti-TNFα therapy show a marginally increased SIR; this is lost in sensitivity analyses. Patients concerned about anti-TNFα-associated demyelination can be relatively reassured by these data.
    MeSH term(s) Adult ; Antibodies, Monoclonal/adverse effects ; Arthritis, Rheumatoid/complications ; Arthritis, Rheumatoid/drug therapy ; Cohort Studies ; Demyelinating Diseases/chemically induced ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Tumor Necrosis Factor Inhibitors/adverse effects ; Tumor Necrosis Factor Inhibitors/therapeutic use ; Tumor Necrosis Factor-alpha/antagonists & inhibitors
    Chemical Substances Antibodies, Monoclonal ; Tumor Necrosis Factor Inhibitors ; Tumor Necrosis Factor-alpha
    Language English
    Publishing date 2021-04-16
    Publishing country United States
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2767740-0
    ISSN 2332-7812 ; 2332-7812
    ISSN (online) 2332-7812
    ISSN 2332-7812
    DOI 10.1212/NXI.0000000000000992
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  5. Article ; Online: Why do the French get much greater access to anti-TNF than the British? Vive la difference? Pas necessairement.

    Deighton, C / Hyrich, K

    Rheumatology (Oxford, England)

    2008  Volume 47, Issue 11, Page(s) 1600–1602

    MeSH term(s) Antirheumatic Agents/therapeutic use ; Arthritis, Rheumatoid/drug therapy ; France ; Guideline Adherence ; Healthcare Disparities ; Humans ; Patient Selection ; Tumor Necrosis Factor-alpha/antagonists & inhibitors ; United Kingdom
    Chemical Substances Antirheumatic Agents ; Tumor Necrosis Factor-alpha
    Language English
    Publishing date 2008-11
    Publishing country England
    Document type Comparative Study ; Editorial ; Comment
    ZDB-ID 1464822-2
    ISSN 1462-0332 ; 1462-0324
    ISSN (online) 1462-0332
    ISSN 1462-0324
    DOI 10.1093/rheumatology/ken353
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    Zs.B 240: Show issues Location:
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  6. Article ; Online: Harnessing repeated measurements of predictor variables for clinical risk prediction: a review of existing methods.

    Bull, Lucy M / Lunt, Mark / Martin, Glen P / Hyrich, Kimme / Sergeant, Jamie C

    Diagnostic and prognostic research

    2020  Volume 4, Page(s) 9

    Abstract: Background: Clinical prediction models (CPMs) predict the risk of health outcomes for individual patients. The majority of existing CPMs only harness cross-sectional patient information. Incorporating repeated measurements, such as those stored in ... ...

    Abstract Background: Clinical prediction models (CPMs) predict the risk of health outcomes for individual patients. The majority of existing CPMs only harness cross-sectional patient information. Incorporating repeated measurements, such as those stored in electronic health records, into CPMs may provide an opportunity to enhance their performance. However, the number and complexity of methodological approaches available could make it difficult for researchers to explore this opportunity. Our objective was to review the literature and summarise existing approaches for harnessing repeated measurements of predictor variables in CPMs, primarily to make this field more accessible for applied researchers.
    Methods: MEDLINE, Embase and Web of Science were searched for articles reporting the development of a multivariable CPM for individual-level prediction of future binary or time-to-event outcomes and modelling repeated measurements of at least one predictor. Information was extracted on the following: the methodology used, its specific aim, reported advantages and limitations, and software available to apply the method.
    Results: The search revealed 217 relevant articles. Seven methodological frameworks were identified: time-dependent covariate modelling, generalised estimating equations, landmark analysis, two-stage modelling, joint-modelling, trajectory classification and machine learning. Each of these frameworks satisfies at least one of three aims: to better represent the predictor-outcome relationship over time, to infer a covariate value at a pre-specified time and to account for the effect of covariate change.
    Conclusions: The applicability of identified methods depends on the motivation for including longitudinal information and the method's compatibility with the clinical context and available patient data, for both model development and risk estimation in practice.
    Language English
    Publishing date 2020-07-09
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2397-7523
    ISSN (online) 2397-7523
    DOI 10.1186/s41512-020-00078-z
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  7. Article ; Online: Rheumatoid arthritis: When TNF inhibitors fail in RA--weighing up the options.

    Silva-Fernandez, Lucia / Hyrich, Kimme

    Nature reviews. Rheumatology

    2014  Volume 10, Issue 5, Page(s) 262–264

    MeSH term(s) Arthritis, Rheumatoid/drug therapy ; Treatment Failure ; Tumor Necrosis Factor Inhibitors
    Chemical Substances Tumor Necrosis Factor Inhibitors
    Language English
    Publishing date 2014-03-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2491532-4
    ISSN 1759-4804 ; 1759-4790
    ISSN (online) 1759-4804
    ISSN 1759-4790
    DOI 10.1038/nrrheum.2014.34
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  8. Article ; Online: Development and implementation of 'A guide to PPIE - Early Integration into Research Proposals' in a multi-disciplinary consortium.

    Beesley, Richard / Luling Feilding, Freya / Rosser, Elizabeth C / Shoop-Worrall, Stephanie J W / McNeece, Alyssia / Wanstall, Zoe / Hyrich, Kimme / Wedderburn, Lucy R

    Rheumatology (Oxford, England)

    2023  Volume 63, Issue 3, Page(s) e88–e91

    Language English
    Publishing date 2023-09-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 1464822-2
    ISSN 1462-0332 ; 1462-0324
    ISSN (online) 1462-0332
    ISSN 1462-0324
    DOI 10.1093/rheumatology/kead482
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  9. Article: Evaluating the real-world benefits and risks of anti-tumor necrosis factor therapies.

    Low, Audrey / Hyrich, Kimme

    The Journal of rheumatology

    2013  Volume 40, Issue 1, Page(s) 4–6

    MeSH term(s) Antirheumatic Agents/adverse effects ; Arthritis, Psoriatic/drug therapy ; Arthritis, Rheumatoid/drug therapy ; Female ; Hospitalization/statistics & numerical data ; Humans ; Male ; Spondylitis, Ankylosing/drug therapy ; Tumor Necrosis Factor-alpha/antagonists & inhibitors
    Chemical Substances Antirheumatic Agents ; Tumor Necrosis Factor-alpha
    Language English
    Publishing date 2013-01
    Publishing country Canada
    Document type Comment ; Editorial
    ZDB-ID 194928-7
    ISSN 1499-2752 ; 0315-162X
    ISSN (online) 1499-2752
    ISSN 0315-162X
    DOI 10.3899/jrheum.121260
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    Zs.MO 135: Show issues

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  10. Article ; Online: What is the impact of biologic therapies on common co-morbidities in patients with rheumatoid arthritis?

    Humphreys, Jenny / Hyrich, Kimme / Symmons, Deborah

    Arthritis research & therapy

    2016  Volume 18, Issue 1, Page(s) 282

    Abstract: Biologic therapies have revolutionised disease control in patients with rheumatoid arthritis (RA). Theoretically, they have the potential to influence co-morbid disease associated with RA through better control of systemic inflammation. Conversely, co- ... ...

    Abstract Biologic therapies have revolutionised disease control in patients with rheumatoid arthritis (RA). Theoretically, they have the potential to influence co-morbid disease associated with RA through better control of systemic inflammation. Conversely, co-morbidity may occur as an adverse effect of the drugs. The latest evidence from observational data shows an increased risk of infection in the first 6 months of treatment with tumour necrosis factor inhibitor (TNFi) therapies and potentially other biologic therapies. Rates of infection after the first 6 months decrease and become comparable to patients with RA treated with conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs). TNFi also appear to reduce the risk of cardiovascular disease in these patients, in particular ischaemic heart disease. TNFi treatment may be associated with a small increase in the risk of developing squamous cell carcinoma of the skin; in terms of other cancers, rates appears to be no different to those seen in patients treated with csDMARDs. There is a paucity of data on the impact of other biologic therapies and the effect of all biologic therapies on other common co-morbidities.
    MeSH term(s) Antirheumatic Agents/therapeutic use ; Arthritis, Rheumatoid/drug therapy ; Comorbidity ; Humans
    Chemical Substances Antirheumatic Agents
    Language English
    Publishing date 2016-12-01
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2107602-9
    ISSN 1478-6362 ; 1478-6354
    ISSN (online) 1478-6362
    ISSN 1478-6354
    DOI 10.1186/s13075-016-1176-x
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