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

Tumor necrosis factor-alpha (TNF alpha) may promote neuroinflammation prompting tinnitus. This retrospective cohort study evaluated whether anti-TNF alpha 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-TNF alpha 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-TNF alpha were selected for comparisons. Tinnitus incidence was compared among patients with or without anti-TNF alpha therapy, overall and among at-risk age groups or by anti-TNF alpha category. High-dimensionality propensity score (hdPS) matching was used to adjust for baseline confounders. Compared with patients with no anti-TNF alpha, anti-TNF alpha 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-TNF alpha category (monoclonal antibody vs. fusion protein: 0.91 [0.59, 1.41]). Anti-TNF alpha 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-TNF alpha therapy was not associated with tinnitus incidence among patients with autoimmune disorders.