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).