Associations of Tinnitus Incidence with Use of Tumor Necrosis Factor-Alpha Inhibitors among Patients with Autoimmune Conditions

Nirvikalpa Natarajan; Shelley Batts; Saurabh Gombar; Raj Manickam; Varun Sagi; Sharon G Curhan; Konstantina M Stankovic

doi:10.3390/jcm12051935

Associations of Tinnitus Incidence with Use of Tumor Necrosis Factor-Alpha Inhibitors among Patients with Autoimmune Conditions

J Clin Med. 2023 Mar 1;12(5):1935. doi: 10.3390/jcm12051935.

Authors

Nirvikalpa Natarajan¹, Shelley Batts¹, Saurabh Gombar^{2

3}, Raj Manickam², Varun Sagi¹, Sharon G Curhan⁴, Konstantina M Stankovic^{1

5

6}

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd, Palo Alto, CA 94304, USA.
² Atropos Health, 71 W 83rd St #3R., New York, NY 10024, USA.
³ Department of Pathology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, USA.
⁴ Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA.
⁵ Department of Neurosurgery, Stanford University School of Medicine, 801 Welch Rd, Palo Alto, CA 94304, USA.
⁶ Wu Tsai Neuroscience Institute, Stanford University, 288 Campus Dr, Stanford, CA 94305, USA.

Abstract

Tumor necrosis factor-alpha (TNFα) may promote neuroinflammation prompting tinnitus. This retrospective cohort study evaluated whether anti-TNFα therapy influences incident tinnitus risk among adults with autoimmune disorders and no baseline tinnitus selected from a US electronic health records database (Eversana; 1 January 2010-27 January 2022). Patients with anti-TNFα had ≥90-day history pre-index (first autoimmune disorder diagnosis) and ≥180-day follow-up post-index. Random samples (n = 25,000) of autoimmune patients without anti-TNFα were selected for comparisons. Tinnitus incidence was compared among patients with or without anti-TNFα therapy, overall and among at-risk age groups or by anti-TNFα category. High-dimensionality propensity score (hdPS) matching was used to adjust for baseline confounders. Compared with patients with no anti-TNFα, anti-TNFα was not associated with tinnitus risk overall (hdPS-matched HR [95% CI]: 1.06 [0.85, 1.33]), or between groups stratified by age (30-50 years: 1 [0.68, 1.48]; 51-70 years: 1.18 [0.89, 1.56]) or anti-TNFα category (monoclonal antibody vs. fusion protein: 0.91 [0.59, 1.41]). Anti-TNFα was not associated with tinnitus risk among those treated for ≥6 months (hdPS-matched HR [95% CI]: 0.96 [0.69, 1.32]) or ≥12 (1.03 [0.71, 1.5]), or those with RA (1.16 [0.88, 1.53]). Thus, in this US cohort study, anti-TNFα therapy was not associated with tinnitus incidence among patients with autoimmune disorders.

Keywords: autoimmune disorders; cohort study; electronic health records; incidence; propensity score matching; tinnitus; tumor necrosis factor-alpha; tumor necrosis factor-alpha inhibitor.

Abstract

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