Impact of Biologic Drugs on Comorbidity Outcomes in Rheumatoid Arthritis: A Systematic Review

Area of Science:

• Rheumatology and Immunology
• Pharmacology
• Internal Medicine

Background:

• Rheumatoid arthritis (RA) management has improved with biologic disease-modifying antirheumatic drugs (bDMARDs).
• Comorbidities significantly impact RA prognosis, increasing morbidity and mortality.
• The effect of bDMARDs on non-RA comorbidities is underexplored.

Purpose of the Study:

• To systematically review the impact of bDMARDs on the progression and outcomes of comorbidities in RA patients.
• To provide evidence for personalized treatment strategies in RA management considering comorbidities.

Main Methods:

• Systematic review registered in PROSPERO (CRD42022345903) and adhering to PRISMA guidelines.
• Searched PubMed and Scopus for original research articles published up to July 18, 2024.
• Included studies assessing bDMARDs' impact on comorbidities in RA patients.

Main Results:

• Thirteen studies were included, examining pulmonary conditions, diabetes, anemia, and malignancies.
• bDMARDs showed potential benefits for anemia (e.g., TNFis, Tocilizumab) and diabetes (e.g., Anakinra for HbA1c).
• No significant increase in malignancy rates or decrease in overall survival was observed.

Conclusions:

• bDMARDs are generally safe in RA patients with comorbidities and may offer specific advantages.
• Personalized bDMARD selection based on comorbidity profile can enhance RA management and comorbidity outcomes.
• Consideration of biologics like Anakinra or Tocilizumab may be beneficial for RA patients with diabetes or anemia.