PT  - JOURNAL ARTICLE
AU  - Arthur N. Lau
AU  - Matthew Wong-Pack
AU  - Rod Rodjanapiches
AU  - George Ioannidis
AU  - Sally Wade
AU  - Leslie Spangler
AU  - Akhila Balasubramanian
AU  - Nicola Pannacciulli
AU  - Celia J.F. Lin
AU  - Patrick Roy-Gayos
AU  - William G. Bensen
AU  - Robert Bensen
AU  - Jonathan D. Adachi
TI  - Occurrence of Serious Infection in Patients with Rheumatoid Arthritis Treated with Biologics and Denosumab Observed in a Clinical Setting
AID  - 10.3899/jrheum.161270
DP  - 2018 Feb 01
TA  - The Journal of Rheumatology
PG  - 170--176
VI  - 45
IP  - 2
4099  - http://www.jrheum.org/content/45/2/170.short
4100  - http://www.jrheum.org/content/45/2/170.full
SO  - J Rheumatol2018 Feb 01; 45
AB  - Objective. Previous studies combining biologic disease-modifying antirheumatic drugs (bDMARD) to treat rheumatoid arthritis (RA) have shown an increased risk of infection. However, the risk of infection with concurrent use of denosumab, a biologic agent for the treatment of osteoporosis, and a bDMARD remains unclear. Here, we evaluated the incidence of serious and opportunistic infections in patients treated concurrently with denosumab and a bDMARD and patients treated with a bDMARD alone.Methods. A chart review of patients with RA from 2 Canadian rheumatology practices between July 1, 2010, and July 31, 2014, identified 2 groups of patients: those taking denosumab and a bDMARD concurrently (concurrent group) and those taking only a bDMARD (biologic-alone group). Patients were followed from the time of initiation of denosumab, or a matched index date for the biologic-alone group, to the end of the study or loss to followup. Instances of serious or opportunistic infections were recorded.Results. A total of 308 patients (n = 102 for the concurrent group and n = 206 for the biologic-alone group) were evaluated. Within the concurrent group, 3 serious infection events occurred. Within the biologic-alone group, 4 serious infection events and 1 opportunistic infection event occurred. In both groups, all patients with serious or opportunistic infection recovered, and there were no instances of death during the study period.Conclusion. This study demonstrated a low occurrence of serious and opportunistic infections in patients with RA taking bDMARD, including patients with concurrent denosumab use.