Biologics are beneficial regarding cardiovascular comorbidity, metabolic comorbidity, rheumatologic comorbidity, and miscellaneous comorbidity in the current study
With an average 15-year follow-up duration, the event rate of different medical comorbidities in the biologics group and in the non-biologics group are shown in Table 2, which compares the incidence of each comorbidity with the usage of biologic agents. This result indicates that the incidence rates of cardiovascular comorbidity, metabolic comorbidity, rheumatologic comorbidity, and miscellaneous comorbidity were all significantly lower in the biologics group (all p<0.05). However, the usage of biologic agents does not change the incidence of oncology or infectious comorbidities (both p>0.05, Table 2).
Outcomes of multivariate-adjusted hazard ratio (HR) of each comorbidity
Both the detailed incidence rate and the hazard ratio (HR) of each comorbidity in RA patients are demonstrated in Table 3. The effects of gender, age, and biologics to each comorbidity were demonstrated separately. The occurrence of cardiovascular comorbidities was 9% higher in male RA patients than in female RA patients (crude HR), or 10% higher with multivariate-adjusted HR. The occurrence of cardiovascular comorbidities was 27.63 times higher in RA patients over the age of 16 years than in RA patients 16 years old and younger (crude HR), or 28.11 times higher with multivariate-adjusted HR. The use of biologic agents in RA patients could reduce both the crude HR and the multivariate-adjusted HR of cardiovascular comorbidities by 18% compared to those patients who did not (Table 3).
The metabolic comorbidities occur 11% more in female RA patients than in male RA patients (crude HR), or 10% more with multivariate-adjusted HR in female RA patients. Metabolic comorbidities are 5.79 times more likely in RA patients over the age of 16 years old than in RA patients 16 years old or younger (crude HR), or 5.72 times higher with multivariate-adjusted HR. The use of biologic agents in RA patients could reduce both the crude HR and the multivariate-adjusted HR of metabolic comorbidities by 17% compared to those patients who did not (Table 3).
Rheumatology comorbidities were 3% higher in female RA patients than in male RA patients (crude HR), or 3% higher with multivariate-adjusted HR. They were 1.25 times higher in RA patients over the age of 16 years old than in RA patients 16 years old or younger (crude HR), or 1.25 times higher with multivariate-adjusted HR. The usage of biologic agents in RA patients could reduce the HR of rheumatology comorbidities by 36% compared to those patients who did not with crude HR and by 35% compared to those patients who did not with the multivariate-adjusted HR. (Table 3).
Oncology comorbidities occurred 25% more in male RA patients than in female RA patients (crude HR), or 26% more with multivariate-adjusted HR. Regarding age, the oncology comorbidities were 3.37 times higher in RA patients over the age of 16 years old than in RA patients 16 years old or younger (crude HR), or 3.5 times higher with multivariate-adjusted HR. The use of biologic agents in RA patients could reduce both the crude HR and the multivariate-adjusted HR of oncology comorbidities by 65% compared to those patients who did not, but we observed no significant statistical differences between users and non-users of biologics (p>0.05) (Tables 2 and 3).
Infection comorbidities were 25% more likely in male RA patients than in female RA patients (crude HR), or 26% more likely with multivariate-adjusted HR. The occurrence of infection comorbidities was 3.37 times higher in RA patients over the age of 16 years old than in RA patients 16 years old or younger (crude HR), or 3.5 times higher with multivariate-adjusted HR. The usage of biologic agents in RA patients could reduce the HR of infection comorbidities by 77% compared to those patients who did not with crude HR and by 81% of those patients who did not with the multivariate-adjusted HR. However, no statistically significant differences were found between users and non-users of biologics (p>0.05) (Tables 2 and 3).
Miscellaneous comorbidities were 6% higher in male RA patients than in female RA patients (crude HR), or 7% higher with multivariate-adjusted HR. The miscellaneous comorbidities were 1.52 times higher in RA patients over the age of 16 years old than in RA patients 16 years old or younger (crude HR), or 1.55 times higher with multivariate-adjusted HR. The usage of biologic agents in RA patients could reduce both the crude HR and the multivariate-adjusted HR of miscellaneous comorbidities to 15% of those patients who did not (Table 3).