Drug Therapy for Rheumatoid Arthritis in Adults
Comparative Adverse Effects of Biologic DMARDs (1 of 3)
The systematic review investigated adverse effects associated with biologic DMARDs in the treatment of rheumatoid arthritis (RA).
The risk of serious infections increases when patients with RA are treated with biologic DMARDs. Six randomized controlled trials with a total of 5,014 patients, 26 observational studies with a total of 391,403 patients, and 6 meta-analyses provided moderate evidence for this conclusion.
Combining two biologic DMARDs leads to substantially higher rates of serious adverse events than monotherapy. Two studies with a total of 363 patients provided moderate evidence for this finding.
The rate of adverse events did not increase over time in long-term studies of adalimumab, anakinra, etanercept, and infliximab. Nine studies with a total of 14,914 patients provided moderate evidence for this finding.
Keywords: adalimumab | adverse effects | adverse events | anakinra | anti-rheumatic | antirheumatic | biologic DMARD | disease-modifying | DMARDs | etanercept | infection | infliximab | RA | rheumatic | rheumatoid arthritis
- Donahue KE, Jonas D, Hansen RA, et al. Drug Therapy for Rheumatoid Arthritis in Adults: An Update. Comparative Effectiveness Review No. 55 (Prepared by the RTI International–University of North Carolina Evidence-based Practice Center under Contract No. 290-2007-10056-I). Rockville, MD: Agency for Healthcare Research and Quality; April 2012. AHRQ Publication No. 12-EHC025-EF. Available at www.effectivehealthcare.ahrq.gov/dmardsra.cfm.
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