Figure 5 :The effect of anti-rheumatic drugs on the clinical
outcomes of autoimmune rheumatic diseases from the perspective of the
main drugs. (1)The hospitalization rates of ARD patients after using
anti-rheumatic drugs. (A) GC, (B) bDMARDs, (C) csDMARDs, (D) anti-TNF
therapy. (2)The ICU admission rates of ARD patients after using
anti-rheumatic drugs. (E) GC, (F) bDMARDs, (G) csDMARDs, (H) anti-TNF
therapy. (3)The mortality of ARD patients after using anti-rheumatic
drugs. (I) GC, (J) bDMARDs, (K) csDMARDs, (L) anti-TNF therapy.
From the perspective of major drugs, the ICU admission rates of ARD
patients using GC, bDMARDs, csDMARDs, and anti-TNF therapy were
0.094(95%CI:0.046-0.152),
0.010(95%CI:0.000-0.037),
0.055(95%CI:0.037-0.075) and 0.022(95%CI:0.000-0.081)(Figure 5). The
ICU admission rates of patients using bDMARDs, csDMARDs and anti-TNF
therapy was lower than the total ICU rate. The mortalities in ARD
patients mainly using GC, bDMARDs, csDMARDs, and anti-TNF therapy were
0.070(95%CI:0.033-0.114), 0.039(95%CI:0.007-0.087),
0.074(95%CI:0.041-0.114) and 0.068(95%CI:0.034-0.111)(Figure 5).
Regression analysis showed that the main use of major drugs was not
associated with the ICU admission and
mortality(Figure p14 and p15).
Since the effect of drugs on clinical outcomes is different in different
diseases, we performed a more detailed stratification. We only selected
the studies in which patients using a certain drug exceeded 50% of the
total cases. In SLE, the hospitalization rates of patients mainly using
GC and csDMARDs were 0.670(95%CI:0.406-0.933) and
0.575(95%CI:0.434-0.716). The mortality due to COVID-19 in these
patients mainly using GC was 0.055(95%CI:0.045-0.065). The
hospitalization rate of SLE patients using GC was higher than those
using DMARDs. The hospitalization rates of RA patients mainly using GC
and csDMARDs were both 0.563(95%CI:0.192-0.934). The mortality of these
patients mainly using GC and csDMARDs were 0.077(95%CI:0.035-0.120) and
0.059(95%CI:0.022-0.109), respectively, the mortality of RA patients
using GC was higher than those of csDMARDs. The hospitalization rates of
CTD patients mainly using csDMARDs was 0.466(95%CI:0.007-0.974)(Figure
p16).