Prediction of infection risk in rheumatoid arthritis patients treated with biologics: are we any closer to risk stratification?

Current Opinion in Rheumatology
Meghna JaniKimme Hyrich

Abstract

There are currently several available biologics for rheumatoid arthritis (RA) with similar efficacy in most trials. A major consideration therefore in choosing a biologic, continues to be safety concerns such as infection. Considerable advances have been made in the understanding of biologic safety on a population level; however, how close are we to stratifying risk for individual patients? This review discusses evidence published in the last year, with reference to key previous literature. Comparative safety of biologics has been studied in observational cohorts, with a possible increased risk of serious infection in tocilizumab-treated patients compared with etanercept. Rheumatoid arthritis patients on biologics are often on concomitant medications such as steroids and opioids, and the advances in relation to infection are summarized. Pharmacological biomarkers and optimizing existing risk prediction scores may allow better future risk stratification. Improved quantification of personalized benefit:harms would allow better-informed decisions, reduction of infection-associated morbidity as well as direct/indirect costs associated with biologics. Although advances have been made to better understand and predict risk, future stu...Continue Reading

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Citations

Jul 16, 2020·Rheumatology International·Francesco MasiniGiovanna Cuomo
Jun 23, 2020·QJM : Monthly Journal of the Association of Physicians·G Rojas-MarteJ Shani
Sep 26, 2020·The Korean Journal of Internal Medicine·Mi Ryoung SeoUNKNOWN Korean College of Rheumatology working group
Oct 8, 2021·Annals of Saudi Medicine·Abdullah Al-SohaimSalim Alawi Baharoone

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