Environmental Air Pollution Is a Predictor of Poor Response to Biological Drugs in Chronic Inflammatory Arthritides.
Journal
ACR open rheumatology
ISSN: 2578-5745
Titre abrégé: ACR Open Rheumatol
Pays: United States
ID NLM: 101740025
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
received:
19
02
2021
accepted:
15
04
2021
pubmed:
2
6
2021
medline:
2
6
2021
entrez:
1
6
2021
Statut:
ppublish
Résumé
There is increasing evidence that environmental air pollution is associated with the development of chronic inflammatory arthritides (CIA). The role of air pollutants on the biological treatment (biological disease-modifying antirheumatic drugs [bDMARDs]) response of CIA is still unclear. We retrieved longitudinal data on patients affected by CIA on biological therapies and on the daily concentration of air pollutants in the Verona area. We designed a case-crossover study to compare the exposure to pollutants in the 60-day period preceding a drug switch or swap due to disease progression referent to the 60-day period preceding a visit with stable treatment for at least 6 months. A total of 1257 patients with CIA (863 with rheumatoid arthritis, 256 with psoriatic arthritis, and 138 with ankylosing spondylitis) with 5454 follow-up visits were included in the study (median follow-up 2.09 years [interquartile range: 0.82-2.58 years]). A total of 282 patients were included in the case-crossover study. We retrieved 13 636 daily air pollution records. We found that air pollutants' concentrations were higher in the 60-day period before a failure of bDMARD response and prior to a switch or swap compared with the period preceding a visit with stable bDMARD therapy for at least 6 months. We found that environmental air pollution was a determinant of poor response to bDMARDs in a cohort of patients with CIA followed over a 5-year period. An intervention aimed at decreasing fossil combustion emissions might have beneficial effects on biologic persistence rates of patients with CIA and economic expenditures related to switches and swaps.
Sections du résumé
BACKGROUND
BACKGROUND
There is increasing evidence that environmental air pollution is associated with the development of chronic inflammatory arthritides (CIA). The role of air pollutants on the biological treatment (biological disease-modifying antirheumatic drugs [bDMARDs]) response of CIA is still unclear.
METHODS
METHODS
We retrieved longitudinal data on patients affected by CIA on biological therapies and on the daily concentration of air pollutants in the Verona area. We designed a case-crossover study to compare the exposure to pollutants in the 60-day period preceding a drug switch or swap due to disease progression referent to the 60-day period preceding a visit with stable treatment for at least 6 months.
RESULTS
RESULTS
A total of 1257 patients with CIA (863 with rheumatoid arthritis, 256 with psoriatic arthritis, and 138 with ankylosing spondylitis) with 5454 follow-up visits were included in the study (median follow-up 2.09 years [interquartile range: 0.82-2.58 years]). A total of 282 patients were included in the case-crossover study. We retrieved 13 636 daily air pollution records. We found that air pollutants' concentrations were higher in the 60-day period before a failure of bDMARD response and prior to a switch or swap compared with the period preceding a visit with stable bDMARD therapy for at least 6 months.
CONCLUSION
CONCLUSIONS
We found that environmental air pollution was a determinant of poor response to bDMARDs in a cohort of patients with CIA followed over a 5-year period. An intervention aimed at decreasing fossil combustion emissions might have beneficial effects on biologic persistence rates of patients with CIA and economic expenditures related to switches and swaps.
Identifiants
pubmed: 34060251
doi: 10.1002/acr2.11270
pmc: PMC8280800
doi:
Types de publication
Journal Article
Langues
eng
Pagination
451-456Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 The Authors. ACR Open Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.
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