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

Abstract:

PURPOSE OF REVIEW: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. RECENT FINDINGS: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. SUMMARY: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 studies are likely to require a range of novel data sources and methodologies for the goal of precision medicine to be truly realized.

journal_name

Curr Opin Rheumatol

authors

Jani M,Barton A,Hyrich K

doi

10.1097/BOR.0000000000000598

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

285-292

issue

3

eissn

1040-8711

issn

1531-6963

journal_volume

31

pub_type

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