Air Pollution Can Impact Response to bDMARDs

Researchers found environmental air pollution to be a determinant of poor response to biological disease-modifying antirheumatic drugs (bDMARDs) in recent study among patients with chronic inflammatory arthritides (CIA) in Italy.

The study followed patients over a 5-year period and revealed “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,” the authors reported. “There is increasing evidence that environmental air pollution is associated with the development of CIA.”

Researchers collected longitudinal data on biological therapies and daily air pollutants concentration among 1257 patients with CIA—863 with rheumatoid arthritis (RA), 256 with psoriatic arthritis (PsA), and 138 with ankylosing spondylitis (AS) in Verona. The study included 5454 follow-up visits over a median follow-up period of 2.09 years.

A total of 282 patients were included in the case-crossover study, along with 13,636 daily air pollution records.

“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. 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,” the authors concluded.

—Angelique Platas

Reference

Adami G, Rossini M, Viapiana, O, et al. Environmental Air Pollution Is a Predictor of Poor Response to Biological Drugs in Chronic Inflammatory Arthritides. ACR Open Rheumatol. 2021;3(7): 451-456. 

DOI: https://doi.org/10.1002/acr2.11270