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Infections With Biologics in Rheumatoid Arthritis and Related Conditions: a Scoping Review of Serious or Hospitalized Infections in Observational Studies

  • Rheumatoid Arthritis (LW Moreland, Section Editor)
  • Published:
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Abstract

Biologic use is a major advance in the treatment of several autoimmune conditions, including rheumatoid arthritis. In this review, we summarize key studies of serious/hospitalized infections in rheumatoid arthritis (RA). RA is a risk factor for infections. High RA disease activity is associated with higher risk of serious infection. The risk of serious infections with tumor necrosis factor inhibitor (TNFi) biologics is increased in the first 6 months of initiating therapy, and this risk was higher compared to the use of traditional disease-modifying anti-rheumatic drugs (DMARDs). Emerging data also suggest that biologics may differ from each other regarding the risk of serious or hospitalized infections. Past history of serious infections, glucocorticoid dose, and older age were other important predictors of risk of serious infections in patients treated with biologics.

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Abbreviations

DMARD:

Disease-modifying anti-rheumatic drugs

RA:

Rheumatoid factor

IBD:

Inflammatory bowel disease

TNFi:

Inhibitors of tumor necrosis factor

HR:

Hazard ratio

IRR:

Incidence rate ratio

CI:

Confidence interval

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Medicine, School of Medicine, University of Alabama at Birmingham, Faculty Office Tower 805B, 510 20th Street S, Birmingham, AL, 35294, USA

    Jasvinder A. Singh

  2. Division of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA

    Jasvinder A. Singh

  3. Medicine Service, Birmingham VA Medical Center, Birmingham, AL, USA

    Jasvinder A. Singh

  4. Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA

    Jasvinder A. Singh

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Correspondence to Jasvinder A. Singh.

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Conflict of Interest

JAS has received research grants from Takeda and Savient and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA, Inc., a 501 (c)(3) entity. JAS is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology’s (ACR) Annual Meeting Planning Committee (AMPC); Chair of the ACR Meet-the-Professor, Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Grant Support

This material is the result of work supported by research funds from UAB Division of Rheumatology and the resources and use of facilities at the Birmingham VA Medical Center.

Additional information

This article is part of the Topical Collection on Rheumatoid Arthritis

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Singh, J.A. Infections With Biologics in Rheumatoid Arthritis and Related Conditions: a Scoping Review of Serious or Hospitalized Infections in Observational Studies. Curr Rheumatol Rep 18, 61 (2016). https://doi.org/10.1007/s11926-016-0609-5

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  • DOI: https://doi.org/10.1007/s11926-016-0609-5

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