Decreased comorbidities in rheumatoid arthritis patients treated with a
biologic agent
Abstract
Objective. Biologics have been linked to both anti-autoimmune and
anti-inflammatory mechanisms. We examine the long-term effects of
biologics on rheumatoid arthritis (RA) patients in a real-world analytic
cohort study using a nationwide database. Design. We designed a cohort
study using the National Health Insurance Research Database in Taiwan
between 1997 and 2010. Methods. Based on biologics and other
anti-rheumatic agent prescriptions, we divided all patients into either
the biologics group or the non-biologics group. The outcomes were the
incidence rate of each comorbidity and the hazard ratio of each
comorbidity between those using biologics and those not. We followed
patients from the index date to the date on which the database ended.
Results. In total, 19,681 patients were eligible for analysis in this
study. During an average follow-up of 15 years, the event rates of each
comorbidity differed significantly between the users and non-users of
biologics with regard to cardiovascular comorbidity, metabolic
comorbidity, rheumatologic comorbidity, and the miscellaneous
comorbidity (all p<0.05). The usage of biologic agents in RA
patients reduced the HR of cardiovascular comorbidities by 18%,
metabolic comorbidities by 17%, rheumatology comorbidities by 36%, and
miscellaneous comorbidities by 15% compared to those patients who did
not use biologics. Oncology comorbidities and infection comorbidities
were not affected by treatment with biologics (p>0.05).
Conclusions. Biologics may have benefits beyond arthritis control with
regard to reducing real-world comorbidities.