Incidence of Interstitial Lung Disease in Patients With Rheumatoid Arthritis Treated With Biologic and Targeted Synthetic Disease-Modifying Antirheumatic Drugs
Main finding · ILD, crude IR per 1000 person-years; adjusted risk vs adalimumabResult — go to the resultAdjusted hazard ratio 0.31 95% CI 0.12–0.78Authors' conclusion
In this retrospective cohort of patients with RA, patients treated with tofacitinib had the lowest incidence of ILD compared with patients treated with all bDMARDs evaluated, and patients treated with tofacitinib had a reduced risk of ILD compared with patients treated with adalimumab after adjusting for important covariates.
Study context
- Population
- Adults with rheumatoid arthritis (RA), ≥1 year continuous enrollment, treated with a b/tsDMARD of interest, without preexisting interstitial lung disease (ILD); Optum Clinformatics Data Mart, December 2003–December 201922,158 female [78%]
- Participants
- 28,559 adults
- Exposure
- New use of adalimumab vs abatacept, rituximab, tocilizumab or tofacitinib
- Adalimumabn = 13,326reference
- Abataceptn = 5,676
- Rituximabn = 5,444
- Tocilizumabn = 2,548
- Tofacitinibn = 1,565
- Outcome
- Development of ILD: crude incidence rates (IRs) and risk across b/tsDMARDs (Cox regression)
Methodological detailsclaims data (Optum Clinformatics Data Mart), Cox-regression models, sensitivity analysis: prevalent new-user cohort design, Data analysed October 2021 to April 2022
- Claims data (Optum Clinformatics Data Mart)
- Cox-regression models
- Sensitivity analysis: prevalent new-user cohort design
- Data analysed October 2021 to April 2022
Main finding
As reported in the abstract
ILD, crude IR per 1000 person-years; adjusted risk vs adalimumab
Adjusted hazard ratio
0.31
95% CI 0.12–0.78
P = 0.009
By group
Tofacitinibvs Adalimumab
aHR 0.31 (95% CI 0.12–0.78); P = 0.009
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| ILD, prevalent new-user cohort sensitivity analysisTofacitinibvs Adalimumab68% reduced risk | 0.32 (0.13–0.82) | P < 0.001 | |
| 0.10.31310Adjusted hazard ratio (log scale) |
Original publication
Incidence of Interstitial Lung Disease in Patients With Rheumatoid Arthritis Treated With Biologic and Targeted Synthetic Disease-Modifying Antirheumatic Drugs. JAMA Netw Open. Published 1 March 2023. doi:10.
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