Rheumatology (Oxford, England) · 2026
Association between biologic exposure and relapse incidence in relapsing polychondritis: a retrospective cohort study.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Nakayama Yoichi, Aitani Yuki, Shirakashi Mirei, Nakajima Toshiki, Yoshida Tsuneyasu, Nishimura Nozomi, Sasai Tsuneo, Hiwa Ryosuke, Tsuji Hideaki, Akizuki Shuji, Murakami Kosaku, Nakashima Ran, Morinobu Akio, Yoshifuji Hajime
Аннотация
OBJECTIVES: Relapsing polychondritis is characterized by recurrent flares, and comparative evidence for relapse prevention using biologics remains limited. We evaluated the association between biologic exposure and relapse incidence.
METHODS: This single-centre retrospective cohort study (Kyoto University Hospital, 2000-23) investigated adults with relapsing polychondritis. Follow-up was divided into periods without biologics (No-Bio), with TNF-α inhibitors (TNFi) or with IL-6 receptor inhibitor (IL-6Ri). Primary outcomes were relapsing polychondritis relapse and hospitalized infection. Period-level incidence rate ratios (IRRs) were estimated using negative binomial regression with a log(person-time) offset and adjusted for prespecified covariates, and adjusted absolute event rates and rate differences were estimated by regression standardization.
RESULTS: Over 503.5 person-years, 55 patients were included (never-Bio, n = 28; ever-Bio, n = 27). Within the ever-Bio cohort, crude relapse rates were 46.9, 22.4 and 12.5 per 100 person-years during the No-Bio, TNFi and IL-6Ri periods, respectively. In adjusted models, both TNFi and IL-6Ri were associated with lower relapse rates than the No-Bio period (TNFi: IRR 0.4, 95% CI 0.2-0.8; adjusted rate difference, -54.0 events per 100 person-years, 95% CI -141.5 to -5.5; IL-6Ri: IRR 0.2, 95% CI 0.1-0.4; adjusted rate difference, -68.3 events per 100 person-years, 95% CI -149.8 to -21.4). Hospitalized infection estimates were imprecise (TNFi: IRR 0.3, 95% CI 0.1-1.4; IL-6Ri: IRR 0.7, 95% CI 0.2-2.6).
CONCLUSION: Biologic exposure was associated with lower relapse rates than during No-Bio periods in relapsing polychondritis, whereas estimates for hospitalized infection were imprecise.
METHODS: This single-centre retrospective cohort study (Kyoto University Hospital, 2000-23) investigated adults with relapsing polychondritis. Follow-up was divided into periods without biologics (No-Bio), with TNF-α inhibitors (TNFi) or with IL-6 receptor inhibitor (IL-6Ri). Primary outcomes were relapsing polychondritis relapse and hospitalized infection. Period-level incidence rate ratios (IRRs) were estimated using negative binomial regression with a log(person-time) offset and adjusted for prespecified covariates, and adjusted absolute event rates and rate differences were estimated by regression standardization.
RESULTS: Over 503.5 person-years, 55 patients were included (never-Bio, n = 28; ever-Bio, n = 27). Within the ever-Bio cohort, crude relapse rates were 46.9, 22.4 and 12.5 per 100 person-years during the No-Bio, TNFi and IL-6Ri periods, respectively. In adjusted models, both TNFi and IL-6Ri were associated with lower relapse rates than the No-Bio period (TNFi: IRR 0.4, 95% CI 0.2-0.8; adjusted rate difference, -54.0 events per 100 person-years, 95% CI -141.5 to -5.5; IL-6Ri: IRR 0.2, 95% CI 0.1-0.4; adjusted rate difference, -68.3 events per 100 person-years, 95% CI -149.8 to -21.4). Hospitalized infection estimates were imprecise (TNFi: IRR 0.3, 95% CI 0.1-1.4; IL-6Ri: IRR 0.7, 95% CI 0.2-2.6).
CONCLUSION: Biologic exposure was associated with lower relapse rates than during No-Bio periods in relapsing polychondritis, whereas estimates for hospitalized infection were imprecise.