Biologic Drugs Aid Rheumatoid Arthritis Sufferers But Also Pose Infection Risk

The success of biologic drugs in fighting rheumatoid arthritis should not diminish concerns that these drugs can also increase the risk of infection in a small number of patients who take them, according to a group of British rheumatologists.

Writing in the May issue of Rheumatology, Dr. Robert Moots, of the University of Liverpool's rheumatology unit, and two colleagues said biologic drugs may cause infections in some patients just by doing their job -- inhibiting the activity of cytokines, which seems to be necessary to effectively treat rheumatoid arthritis.

The biologics etanercept and infliximab were recently recommended by British health authorities for the treatment of refractory rheumatoid arthritis.

However, the authors noted that some patients, despite warnings to discontinue treatment, have continued on out of the fear that their joint problems associated with rheumatoid arthritis will return.

"Patient education is therefore an ongoing process and not just a single intervention at the start of treatment," said Moots and his colleagues, noting that patients receiving biologics should have ready access to professional advice 24 hours a day.

Moots added that many patients will fulfill the guidelines for biologic therapy, but not all will be ideal candidates. "The onus on us is to maximize patient safety through careful patient selection, education and safety monitoring," he said.

Other sources: Rheumatology 2003;42:614-616