Risk of serious infection with non-biologic DMARD use tripled in patients with RA
Patients with rheumatoid arthritis treated with non-biologic disease-modifying anti-rheumatic drugs had three times the risk for developing a serious infection compared with the general population, according to research by Elizabeth Arkema, ScD, and colleagues, presented at the European League Against Rheumatism Annual European Congress of Rheumatology.
Using the Swedish National Patient Register and the National Prescription Drug Register, researchers identified 12,128 patients with rheumatoid arthritis (RA) who received at least two non-biologic disease-modifying anti-rheumatic drugs (nbDMARDs) during the study period. Patients with prior history of biologic DMARD use were excluded. The researchers also identified 112,925 general population comparators from the database.
Elizabeth Arkema, ScD
Patients who switched nbDMARDs more than 60 days apart outnumbered patients who switched to a new nbDMARD more than 180 days apart and those who switched more than 365 days apart (9,437 vs. 6,190 and 3,801). Additionally, 2,929 patients switched twice during the study period, and 689 switched medications three times.
Compared with a 2.2% risk observed in the general population, the risk for developing a serious infection within the first year of treatment was 6.1% in patients with RA treated with a nbDMARD. For patients who switched medications for the first time during the study, the risk was 6.1% vs. 6% for second-time switchers and 6.8% for patients who switched medications three times within the study period.
During the study period, six of every 100 patients with RA who switched to a different nbDMARD were hospitalized with an infection within 1 year of new treatment initiation, whereas the risk for a serious infection in the general population remained constant over time, according to the researchers. – by Shirley Pulawski
Arkema E, et al. Paper #FRI0064. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.
Disclosure: The researchers report no relevant financial disclosures.