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Respiratory Risks Not Increased in RA Patients with COPD

An insurance claims based study of rheumatoid arthritis (RA) patients with chronic obstructive pulmonary disease (COPD) shows that biologics do not have an increased rate of respiratory events compared to those on conventional DMARDs.

A real world cohort of RA patients with COPD was drawn from US-based MarketScan databases. Patients on biologic DMARDs and/or targeted synthetic DMARDs (tsDMARDs) were propensity matched to those on conventional synthetic DMARDs (csDMARDs).

The study compared 7424 RA/COPD patients initiating biologic/tsDMARDs to 7424 patients initiating csDMARDs.

Comparing biologic/tsDMARD vs csDMARD shows the adjusted hazard ratio for:

  • hospitalized COPD exacerbation = 0.76 (95% CI: 0.55, 1.06)
  • bronchitis = HR 1.02 (95% CI: 0.82, 1.27)
  • hospitalized pneumonia or influenza = 1.21 (95% CI: 0.92, 1.58)
  • outpatient pneumonia or influenza=  0.99 (95% CI: 0.87, 1.12)

The hazard ratio of the combined end point of COPD exacerbation, bronchitis and hospitalized pneumonia or influenza was 1.04 (95% CI: 0.89, 1.21).

Biologic and tsDMARDs appear to be safe to use in RA patients with COPD, having a low risk of adverse respiratory events.

The author has received compensation as an advisor or consultant on this subject

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