Abatacept versus tumor necrosis factor inhibitors on mortality and medical utilizations in the treatment of rheumatoid arthritis associated interstitial lung disease: a large-scale real-world retrospective cohort study
机构：[1]Institute of Medicine, Chung Shan Medical University, South District, No. 110, Section 1, Jianguo North Road, 402 Taichung, Taiwan [2]Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Changhua Christian Hospital, No. 135, NanXiao Street, 500 Changhua, Taiwan [3]Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan[4]School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan [5]Department of Rheumatology and Immunology, First Afliated Hospital of Army Medical University, Chongqing, People’s Republic of China [6]Center for Health Data Science, Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan [7]Department of Rheumatology and Immunology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, People’s Republic of China [8]Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan [9]Department of Nursing, Chung Shan Medical University, Taichung, Taiwan [10]Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
Rheumatoid arthritis is a chronic inflammatory disease, and interstitial lung disease is one of the important extra-articular manifestations. There is limited evidence comparing abatacept (ABA) and tumor necrosis factor inhibitors (TNFi) regarding the risk of mortality among patients with rheumatoid arthritis associated interstitial lung disease (RA-ILD). The aim of this study is to investigate the risk of mortality in patients with RA-ILD treated with ABA compared to TNFi. This retrospective cohort study utilized TriNetX electronic health record database. We enrolled patients who were diagnosed with RA-ILD and had received a new prescription for either ABA or TNFi. Patients were categorized into two cohorts based on their initial prescription. The primary outcome was all-cause mortality, and secondary outcomes were healthcare utilizations, including hospitalization, critical care services, and mechanical ventilation. Subgroup analyses were performed on age, presence of anti-citrullinated peptide antibodies (ACPA), and cardiovascular risk. Among 34,388 RA-ILD patients, 895 were selected for each group (ABA and TNFi) following propensity score matching. The ABA group exhibited a higher all-cause mortality risk. (HR 1.296, 95% CI 1.006-1.671). Subgroup analysis showed a heightened risk of receiving mechanical ventilation in ABA-treated patients aged 18-64 years old (HR 1.853, 95% CI 1.002-3.426), and those with cardiovascular risk factors (HR 2.015, 95% CI 1.118-3.630). Another subgroup analysis indicated a higher risk of mortality among ABA-treated patients with positive-ACPA. (HR 4.138 95% CI 1.343-12.75). This real-world data research demonstrated a higher risk of all-cause mortality in RA-ILD patients treated with ABA compared to TNFi, particularly those aged 18-64 years, lacking cardiovascular risk factors, and positive-ACPA. ABA was associated with an increased risk of mechanical ventilation in patients aged 18-64 years and those with cardiovascular risk factors.
基金：
Chung Shan Medical University Hospital (Grant Numbers CSH-2022-A-001 and CSH-2021-D-001).
第一作者机构：[1]Institute of Medicine, Chung Shan Medical University, South District, No. 110, Section 1, Jianguo North Road, 402 Taichung, Taiwan [2]Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Changhua Christian Hospital, No. 135, NanXiao Street, 500 Changhua, Taiwan
共同第一作者：
通讯作者：
通讯机构：[1]Institute of Medicine, Chung Shan Medical University, South District, No. 110, Section 1, Jianguo North Road, 402 Taichung, Taiwan [8]Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan [9]Department of Nursing, Chung Shan Medical University, Taichung, Taiwan [10]Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
推荐引用方式(GB/T 7714)：
Shih Po-Cheng,Lai Chih-Cheng,Zou Qing-Hua,et al.Abatacept versus tumor necrosis factor inhibitors on mortality and medical utilizations in the treatment of rheumatoid arthritis associated interstitial lung disease: a large-scale real-world retrospective cohort study[J].CLINICAL AND EXPERIMENTAL MEDICINE.2024,24(1):doi:10.1007/s10238-024-01448-3.
APA：
Shih, Po-Cheng,Lai, Chih-Cheng,Zou, Qing-Hua,Wang, Shiow-Ing,Huang, Xiang-Yang&Wei, James Cheng Chung.(2024).Abatacept versus tumor necrosis factor inhibitors on mortality and medical utilizations in the treatment of rheumatoid arthritis associated interstitial lung disease: a large-scale real-world retrospective cohort study.CLINICAL AND EXPERIMENTAL MEDICINE,24,(1)
MLA：
Shih, Po-Cheng,et al."Abatacept versus tumor necrosis factor inhibitors on mortality and medical utilizations in the treatment of rheumatoid arthritis associated interstitial lung disease: a large-scale real-world retrospective cohort study".CLINICAL AND EXPERIMENTAL MEDICINE 24..1(2024)
