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Serious infection rate low in patients with RA treated with biologic DMARDs, denosumab
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Patients with rheumatoid arthritis who take biologic disease-modifying antirheumatic drugs, including those with concurrent denosumab use, demonstrated a low occurrence of serious and opportunistic infections, according to a study published in the Journal of Rheumatology.
“Given the well-recognized risk of bone loss associated with RA, patients with RA are often given pharmacotherapy for osteoporosis,” Arthur N. Lau, MD, assistant professor at McMaster University, in Ontario, Canada, and colleagues wrote. “Oral bisphosphonates have long been the mainstay in the treatment of osteoporosis. Denosumab, a novel anti-resorptive agent used for the treatment of osteoporosis provides an alternative.”
The researchers added, “Nonetheless, given the possibility of increased risk of infection among patients treated with denosumab, there is an interest in understanding the safety of using denosumab to treat osteoporosis in patients being treated for RA with other biologic drugs.”
To evaluate the incidence of serious and opportunistic infections among patients treated with denosumab and biologic disease-modifying antirheumatic drugs (DMARD) concurrently, as well as those taking biologic DMARD alone, the researchers conducted a chart review of 308 patients with RA from two Canadian rheumatology practices between July 1, 2010, and July 31, 2014. The researchers identified 102 patients taking denosumab and biologic DMARD concurrently, and 206 taking the biologic alone.
Investigators followed patients from the time of denosumab initiation, or a matched index date for those taking the biologic alone, and recorded instances of serious or opportunistic infections.
According to Lau and his colleagues, three serious infection events occurred within the concurrent group. Within the biologic-alone group, the researchers reported four serious infection events, and one opportunistic infection event. In both groups, all patients who experienced infection eventually recovered, and there were no instances of death during the study period.
“Results from our study suggest that few patients with RA concurrently treated with a biologic DMARD and denosumab had serious infections or opportunistic infections,” Lau and colleagues wrote. “The small number of infections observed is consistent with that reported in previous cohort studies and provides additional evidence of the safety of concurrent treatment with denosumab and a biologic DMARD. Future studies using larger cohorts could shed further light on this important question.” – by Jason Laday
Disclosure: Lau reports receiving consulting fees, speaking fees, and/or honoraria from Amgen Inc. See the full study for additional author disclosures.
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