In a nutshell
This study examined the link between biological drugs and serious infections in patients with rheumatoid arthritis. The authors concluded that patients treated with biological drugs have a lower risk of mortality and sepsis after a serious infection.
Some background
In rheumatoid arthritis (RA), the immune system attacks the healthy joints the way it would a virus or bacteria. Biological disease-modifying antirheumatic drugs (DMARDs), such as abatacept (Orencia) and tocilizumab (Actemra), are a treatment option for RA. These drugs work by blocking the activity of proteins that are known to contribute to the over-activation of the immune system.
Blocking the immune system can lead to serious infections (SIs). Bone infections, pneumonia and other serious respiratory infections are the most common types of SIs seen in RA patients. If SIs are not cured they can progress into sepsis (when bacteria enters the bloodstream). Sepsis can increase the risk of mortality. It is not clear what effect biological DMARDs have on the development of sepsis following an SI.
Methods & findings
This study examined whether biological DMARDs affect the development of sepsis or mortality rates in RA patients with SIs.
947 patient records were gathered from an ongoing study in Germany that records RA patient data on a continual basis. These patients were receiving either biological or synthetic DMARDS (such as methotrexate) and all showed signs of at least one SI.
The SIs included in this study were bone and joint infections, pneumonia and other serious respiratory infections.
135 patients reported sepsis within 30 days of an SI. Patients receiving biological DMARDs at the time of SI were 44% less likely to develop sepsis than patients receiving synthetic DMARDS. Age and chronic kidney disease played a significant role in the development of sepsis. Physical function and pre-existing conditions also had an effect on sepsis and survival in patients with SIs.
Survival rates were also higher overall in patients receiving biological DMARDs compared to patients receiving synthetic DMARDS.
The bottom line
This study concluded that the use of biological DMARDS for RA patients with serious infections can lead to lower levels of sepsis and higher rates of survival when compared with synthetic DMARDs.
What’s next?
Consult with your physician on the proper management of serious infections.
Published By :
Annals of the rheumatic diseases
Date :
Nov 13, 2015
